Severe Anion Gap Acidosis Associated with Intravenous Sodium Thiosulfate Administration

Michael Mao, Sarah Lee, Kianoush Kashani, Robert Albright, Qi Qian

Research output: Contribution to journalArticle

8 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)274-277
Number of pages4
JournalJournal of Medical Toxicology
Volume9
Issue number3
DOIs
StatePublished - Sep 1 2013

Fingerprint

Acid-Base Equilibrium
Acidosis
Chronic Renal Insufficiency
Calciphylaxis
sodium thiosulfate
Creatinine
Differential Diagnosis
Acids
Pharmaceutical Preparations

Keywords

  • Anion gap acidosis
  • Calciphylaxis
  • Chronic kidney disease
  • GOLD MARKS
  • Sodium thiosulfate (STS)

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

Severe Anion Gap Acidosis Associated with Intravenous Sodium Thiosulfate Administration. / Mao, Michael; Lee, Sarah; Kashani, Kianoush; Albright, Robert; Qian, Qi.

In: Journal of Medical Toxicology, Vol. 9, No. 3, 01.09.2013, p. 274-277.

Research output: Contribution to journalArticle

Mao, Michael ; Lee, Sarah ; Kashani, Kianoush ; Albright, Robert ; Qian, Qi. / Severe Anion Gap Acidosis Associated with Intravenous Sodium Thiosulfate Administration. In: Journal of Medical Toxicology. 2013 ; Vol. 9, No. 3. pp. 274-277.
@article{756637ab240f4f63ad1f3066a1e83727,
title = "Severe Anion Gap Acidosis Associated with Intravenous Sodium Thiosulfate Administration",
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.",
keywords = "Anion gap acidosis, Calciphylaxis, Chronic kidney disease, GOLD MARKS, Sodium thiosulfate (STS)",
author = "Michael Mao and Sarah Lee and Kianoush Kashani and Robert Albright and Qi Qian",
year = "2013",
month = "9",
day = "1",
doi = "10.1007/s13181-013-0305-z",
language = "English (US)",
volume = "9",
pages = "274--277",
journal = "Journal of Medical Toxicology",
issn = "1556-9039",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Severe Anion Gap Acidosis Associated with Intravenous Sodium Thiosulfate Administration

AU - Mao, Michael

AU - Lee, Sarah

AU - Kashani, Kianoush

AU - Albright, Robert

AU - Qian, Qi

PY - 2013/9/1

Y1 - 2013/9/1

N2 - 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.

AB - 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.

KW - Anion gap acidosis

KW - Calciphylaxis

KW - Chronic kidney disease

KW - GOLD MARKS

KW - Sodium thiosulfate (STS)

UR - http://www.scopus.com/inward/record.url?scp=84883824255&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883824255&partnerID=8YFLogxK

U2 - 10.1007/s13181-013-0305-z

DO - 10.1007/s13181-013-0305-z

M3 - Article

VL - 9

SP - 274

EP - 277

JO - Journal of Medical Toxicology

JF - Journal of Medical Toxicology

SN - 1556-9039

IS - 3

ER -