Successful Treatment of Calcific Uremic Arteriolopathy with Sodium Thiosulfate in a Renal Transplant Recipient

Figures & data

Figure 1. (A) Early stage of calcific uremic arteriolopathy (CUA) skin lesions on the right medial calf. (B) Progressive CUA skin lesions appear as deep necrotic ulcers on the bilateral lower limbs. (C) Resolution of CUA skin lesions after STS treatment.

Figure 2. Histology demonstrating the extensive medial calcification of the small-sized arteries in the subcutaneous tissue, which is typical of calcific uremic arteriolopathy (CUA).

Table 1. Serum creatinine, calcium–phosphate parameters, and acid–base status before, during, and after sodium thiosulfate therapy.

	Reference range	Pre-STS therapy	One week after STS therapy	At the end of STS therapy
Creatinine (μmol/L)	50–120	201	184	188
Calcium (mmol/L)	2.10–2.50	2.13	1.99	2.35
Phosphate (mmol/L)	0.65–1.45	1.27	1.66	0.95
Calcium–phosphate product		2.71	3.30	2.23
Albumin (g/L)	34–48	36	17	38
Parathyroid hormone (pmol/L)	0.8–5.5	27.9	9.6	22.1
Bicarbonate (mmol/L)	22–32	16	19	20
Anion gap (mmol/L)	7–17	18	17	12

Note: STS, sodium thiosulfate.