关于在腹膜透析(PD)患者中使用硫代硫酸钠(STS)治疗钙化的数据有限,虽然它在血液透析(HD)患者中得到了充分的研究。使用OvidMEDLINE进行了系统的文献检索,EBM评论-Cochrane中央对照试验登记册,和EBM评论-Cochrane系统评论数据库,以确定接受STS的患有钙化的PD患者的报告病例。搜索涵盖了到2022年8月数据库的开始。在19篇文章中,本综述确定了30例接受STS治疗的PD患者。其中包括15例病例报告,2个案例系列,和2个队列研究。施用途径和剂量根据研究而变化。对于静脉内(IV)给药(n=18),STS剂量范围从每天两次3.2g到每周三次25g,持续5周至8个月。结果包括44%的患者成功愈合伤口,6%因不良反应停止STS,67%过渡到HD,50%死于钙化并发症。对于腹膜内(IP)给药(n=5),STS剂量为12.5至25g,每周3至4次,持续12小时至3个月。结果显示80%的患者伤口愈合成功,80%因不良影响而停止STS,40%过渡到HD,20%的人死于与IPSTS相关的化学性腹膜炎。如果患者从IV切换到IPSTS(n=3),剂量范围为12.5至25克,每周2至3次,持续2.5至5个月。其中,67%的人伤口愈合成功,而33%死于败血症。两例使用口服STS,剂量为1500毫克,每天两次,持续6个月和11个月,导致成功的伤口愈合,没有副作用或需要HD。然而,1例(50%)因小肠梗阻死亡.本系统综述概述了STS治疗患有钙化的PD患者。虽然存在成功的治疗病例,不良反应显著。进一步研究,包括更大的临床研究和药代动力学数据,是建立最佳路线所必需的,剂量,和STS在PD患者中的疗效。
Limited data are available on the utilization of sodium thiosulfate (STS) treatment for
calciphylaxis in peritoneal dialysis (PD) patients, while it is well-studied in hemodialysis (HD) patients. A systematic literature search was conducted using Ovid MEDLINE, EBM Reviews-Cochrane Central Register of Controlled Trials, and EBM Reviews-Cochrane Database of Systematic Reviews to identify reported cases of PD patients with
calciphylaxis who received STS. The search covered the inception of the databases through August 2022. Across 19 articles, this
review identified 30 PD patients with
calciphylaxis who received STS. These included 15 case reports, 2 case series, and 2 cohort studies. The administration routes and doses varied depending on the study. For intravenous (IV) administration (n = 18), STS doses ranged from 3.2 g twice daily to 25 g three times weekly for 5 weeks to 8 months. Outcomes included 44% of patients experiencing successful wound healing, 6% discontinuing STS due to adverse effects, 67% transitioning to HD, and 50% dying from
calciphylaxis complications. For intraperitoneal (IP) administration (n = 5), STS doses ranged from 12.5 to 25 g three to four times weekly for 12 h to 3 months. Results showed 80% of patients achieving successful wound healing, 80% discontinuing STS due to adverse effects, 40% transitioning to HD, and 20% dying from IP STS-related chemical peritonitis. In cases where patients switched from IV to IP STS (n = 3), doses ranged from 12.5 to 25 g two to three times weekly for 2.5 to 5 months. Among them, 67% experienced successful wound healing, while 33% died from sepsis. Two cases utilized oral STS at a dose of 1500 mg twice daily for 6 and 11 months, resulting in successful wound healing without adverse effects or need for HD. However, one patient (50%) died due to small bowel obstruction. This systematic
review provides an overview of STS treatment for PD patients with
calciphylaxis. Although successful treatment cases exist, adverse effects were significant. Further research, including larger clinical studies and pharmacokinetic data, is necessary to establish the optimal route, dose, and efficacy of STS in PD patients.