Possibly enhanced Gd excretion in dialysate, but no major clinical benefit of 3-5 months of treatment with sodium thiosulfate in late stages of nephrogenic systemic fibrosis.

Abstract

BACKGROUND:

Gd-related nephrogenic systemic fibrosis was successfully treated with intravenous sodium thiosulfate according to a recent case report.

METHODS:

Four haemodialysis patients with severe Gd-related nephrogenic systemic fibrosis were treated with intravenous sodium thiosulfate for 3-5 months. Symptoms and patients' experiences were investigated. The dialysate Gd content was monitored.

RESULTS:

We observed no major clinical improvements in any patient. In one patient, we found slightly improved joint motion. Two patients had a subjective impression of slight improvements of joint motion and skin abnormalities. The dialysate Gd content was raised by the treatment, up to fivefold.

CONCLUSIONS:

We could not confirm that sodium thiosulfate treatment results in marked and rapid improvement in late stages of Gd-related nephrogenic systemic fibrosis. However, dialysate contents of Gd seemed to increase. It is unknown whether increased Gd excretion will lead to long-term clinical improvements in late stages of nephrogenic systemic fibrosis.

• Authors: Peter Marckmann, Arne Høj Nielsen, Jens Jørgen Sloth
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 23 Issue 10 Pg. 3280-2 (Oct 2008) ISSN: 1460-2385 [Electronic] England
• PMID: 18436563 (Publication Type: Case Reports, Journal Article)

Chemical References

• Chelating Agents
• Contrast Media
• Hemodialysis Solutions
• Thiosulfates
• gadodiamide
• Gadolinium
• sodium thiosulfate
• Gadolinium DTPA

Topics

• Adult
• Chelating Agents (therapeutic use)
• Contrast Media (adverse effects, pharmacokinetics)
• Female
• Gadolinium (adverse effects, pharmacokinetics)
• Gadolinium DTPA (adverse effects, pharmacokinetics)
• Hemodialysis Solutions (analysis)
• Humans
• Magnetic Resonance Imaging (adverse effects)
• Middle Aged
• Nephrogenic Fibrosing Dermopathy (drug therapy, etiology, metabolism, prevention & control)
• Renal Dialysis
• Renal Insufficiency (diagnosis)
• Thiosulfates (therapeutic use)
• Time Factors