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COMMENTS AND OPINIONS
Sodium Thiosulfate as First-Line Treatment for Calciphylaxis—Reply
Maria R. Robinson, MD;
Joshua J. Augustine, MD;
Neil J. Korman, MD, PhD
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In reply
We thank Ackermann et al for their comments regarding our case report of a patient with calciphylaxis and secondary hyperparathyroidism treated with cinacalcet.1 Cinacalcet treatment is indicated for dialysis patients with secondary hyperparathyroidism whose parathyroid hormone level is greater than 300 pg/mL. Our patient developed severe secondary hyperparathyroidism associated with parathyroid hormone levels as high as 1080 pg/mL (reference range, 7-53 pg/mL) and with varying calcium and phosphorous levels. Although not receiving dialysis, he was considered a good candidate for cinacalcet therapy with close monitoring of his parathyroid hormone, calcium, and phosphorous levels. Throughout therapy, his lowest measured parathyroid hormone level was 147 pg/mL, near the National Kidney Foundation–Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI)2 recommended range for patients with stage 5 chronic kidney disease (150-300 pg/mL).
Adynamic bone disease is a common form of osteodystrophy . . . [Full Text of this Article]
AUTHOR INFORMATION
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