Management of sodium thiosulfate on subcutaneous and vascular calcification of right hand in end-stage renal disease: a case report

Management of sodium thiosulfate on subcutaneous and vascular calcification of right hand in end-stage renal disease: a case report

Subcutaneous and vascular calcifications are severe complications of renal failure characterized by calcification of small arteries and tissues. A 30-year-old female with end stage renal disease due to diabetic nephropathy was prescribed peritoneal dialysis treatment regimen for four years. At her monthly clinic visit, the patient complained of burning sensation in fingers of her right hand with limited fine motor movement due to edema and severe pain. A presumptive diagnosis of subcutaneous and vascular calcification led to hospital admission with confirmation by MRI scan of her hands. The patient continued peritoneal dialysis with low calcium diet, aggressive reduction in phosphorus, diet counseling, use of cinacalcet, and three months of intravenous sodium thiosulfate infusion three times per week for three months. The patient’s condition improved with resolution of symptoms and radiologic findings.