Calcific uremic arteriolopathy: treatment with intraperitoneal sodium thiosulfate in a patient on peritoneal dialysis

Though CUA therapy with IP sodium thiosulfate represents an off-label usage of the drug, reports of its successful use are on the rise. It continues to be successfully administered both IP and IV, and in adult and pediatric populations. The long-term effects of IP sodium thiosulfate on the transport characteristics of the peritoneal membrane are not currently known, so they are an area for future research. Because the disease is so uncommon, small sample sizes limit the development of large, longitudinal studies. Treatment for patients on PD with CUA does not differ from that of other populations, with the one exception being the IP route of sodium thiosulfate administration. Another important aspect of treating this disease that merits mention is tracking through calciphylaxis registries that compile information on patients with calciphylaxis worldwide and disseminate information about treatment practices (for example, a registry is maintained by the University of Kansas Medical Center [2012]). Registries such as this provide a valuable database that may one day lead to improved approaches in the treatment of this uncommon, debilitating, and often fatal disease.