Work

Sodium Thiosulfate for Refractory Metabolic Alkalosis From Diuretic Therapy: A Case Series of Six Patients

Year: 2026

Type: article

Abstract: Loop and thiazide diuretics can cause metabolic alkalosis. Standard treatments for management of alkalosis in patients requiring continued decongestion are not always successful. Sodium thiosulfate (STS) is known to cause metabolic acidosis. We describe the use of STS for diuretic-induced metabolic alkalosis in 6 patients with unresolved hypervolemia requiring continued decongestion in whom standard treatments (acetazolamide, potassium-sparing diuretics) failed. This intervention was effective and without immediate adverse effects, offering a novel strategy for this clinical problem. Given the large sodium load, STS should be reserved for refractory alkalosis in patients on optimal diuretic therapy with an adequate natriuretic response.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2025.0968

Authors: Danny Yang, Bethany Roehm, Peter Van Buren, Kamalanathan K. Sambandam

Institutions: The University of Texas Southwestern Medical Center, VA North Texas Health Care System

Language: English

Topic: Renal function and acid-base balance

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7204874088

FWCI:

Cites: 14

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