The mechanism and clinical application of sodium thiosulfate intreatment of calcific uremic arteriolopathy

Calcific uremic arteriopathy(CUA),also known as calciphylaxis,is a rare but devastating disease that predominantly affects patients with end-stage renal disease receiveing dialysis.It is characterized by profoundly painful ischemic skin necrosis and severe pain.Due to its most poor prognosis,increasingly it has attracted more and more attention.However,there are no high quality clinical trials or corresponding treatment guidelines yet.It is thought that Sodium thiosulfate(STS) as a strong antioxidant may allay pain rapidly by chelating the calcium in deposits and up-regulating calcification inhibitors to inhibit vascular calcification;it is also thought to have a role of vasodilating,endothelium function improving,and pain reliving.STS has now become an important medicine for CUA.In this review,we outline the pharmacokinetic characteristics,mechanism,usage,and adverse reactions of STS for CUA