Sodium Thiosulfate Prescription for Hemodialysis Patients

Standard Dosing Protocol

• For hemodialysis patients requiring sodium thiosulfate for vascular calcification, the Kidney International recommends prescribing 12.5-25 grams intravenously administered 2-3 times per week immediately following each hemodialysis session for 3-6 months 1

Dosing Recommendations

• The standard dose is 25 grams per session, 3 times weekly, and a lower dose option of 12.5 grams per session can be considered if concerned about adverse effects, as recommended by the Kidney International 1
• The treatment duration should be 3-6 months, then reassess based on clinical response, according to the Kidney International 1

Common Adverse Effects and Management

• Gastrointestinal disturbances are dose-dependent, and dose reduction should be considered if severe, as noted by the Kidney International 1

Critical Monitoring Requirements

• Bone mineral density should be monitored, as significant hip bone density decline can occur with higher doses, and consider DEXA scanning at baseline and 6 months, as recommended by the Kidney International 1

Sample Prescription Format

• The prescription format should include a dose of 25 grams (two 50 mL vials) IV, diluted in 100 mL normal saline or 5% dextrose, infused over 60 minutes, administered immediately after each hemodialysis session, three times weekly, for 3-6 months, then reassess, as recommended by the Kidney International 1