Abstract
Introduction
Severe anion gap (AG) acidosis associated with intravenous sodium thiosulfate (STS) administration has not been previously described in nondialysis chronic kidney disease (CKD) patients.
Case Report
We present a CKD patient with a baseline creatinine 1.8 mg/dL (eGFR 28 ml/min/1.73 m2) who developed sustained and life-threatening AG acidosis associated with intravenous STS treatment for calciphylaxis.
Discussion
Although marketed as a safe drug, STS can cause life-threatening acidosis as illustrated in this case. STS-induced AG acidosis should be considered in the differential diagnosis of severe acidosis in patients receiving STS. Dosage adjustment and close follow-up of patients’ acid–base status after STS initiation is necessary.
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Mao, M., Lee, S., Kashani, K. et al. Severe Anion Gap Acidosis Associated with Intravenous Sodium Thiosulfate Administration. J. Med. Toxicol. 9, 274–277 (2013). https://doi.org/10.1007/s13181-013-0305-z
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DOI: https://doi.org/10.1007/s13181-013-0305-z