What is your approach to using intraperitoneal sodium thiosulfate for a patient with ESKD on peritoneal dialysis who develops calciphylaxis?
What is your initial approach to using intraperitoneal sodium thiosulfate for a patient with ESKD on peritoneal dialysis who develops calciphylaxis?
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I believe if the patient has calciphylaxis, PD should not be continued, and more efficient IHD or HHD with the addition of sodium thiosulfate is better.
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I see no reason not to continue PD while using sodium thiosulfate. Though intraperitoneal administration of sodium thiosulfate may cause chemical peritonitis, the drug often can be administered successfully via this route (see Teh & Renaud, PMID 37131321). And even if IP administration does result in chemical peritonitis, the drug may be administered thrice weekly via a central venous catheter while PD continues to facilitate removal along with the chelated calcium. I am using this approach pres...
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