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The Effect of Sodium Thiosulfate on Coronary Artery Calcification in Hemodialysis Patients

Zhixiang Bian1, Qin Zhang, Li Shen

  • 1From the Department of Nephrology, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 23, 2021
PubMed

Insights

Sodium thiosulfate effectively reduced coronary artery calcification (CAC) and improved symptoms in hemodialysis patients with secondary hyperparathyroidism. Routine treatment alone did not significantly alter these markers.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Endocrinology

Background:

  • Secondary hyperparathyroidism is a common complication in hemodialysis patients.
  • Vascular calcification, particularly coronary artery calcification (CAC), is a significant predictor of cardiovascular morbidity and mortality in this population.
  • Effective management strategies are needed to control disease progression and improve patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of sodium thiosulfate in managing secondary hyperparathyroidism in hemodialysis outpatients.
  • To assess the impact of sodium thiosulfate on serum markers, coronary artery calcification (CAC) scores, and clinical symptoms.
  • To compare the outcomes of sodium thiosulfate treatment with routine care.

Main Methods:

  • A randomized controlled trial design was employed, dividing patients into a control group (routine treatment) and a treatment group (routine treatment plus sodium thiosulfate).
  • Serum levels of calcium, phosphorus, parathyroid hormone (PTH), and C-reactive protein were monitored.
  • Coronary artery calcification (CAC) scores were assessed using imaging techniques.
  • Clinical symptoms such as skin pruritus, myasthenia, bone pain, insomnia, and restless legs syndrome were evaluated pre- and post-treatment.

Main Results:

  • The treatment group showed significant reductions in C-reactive protein levels and CAC scores post-intervention.
  • No significant changes in serum calcium, phosphorus, PTH, calcium-phosphorus product, or CAC scores were observed in the control group.
  • The incidence of clinical symptoms significantly decreased in the sodium thiosulfate group compared to baseline, while the control group showed no significant improvement.

Conclusions:

  • Sodium thiosulfate demonstrates a clear benefit in reducing elevated CAC levels in hemodialysis patients.
  • This treatment approach effectively alleviates common clinical symptoms associated with secondary hyperparathyroidism in this cohort.
  • Sodium thiosulfate represents a promising therapeutic option for managing cardiovascular complications in hemodialysis patients.

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