Sodium Thiosulfate for Refractory Metabolic Alkalosis From Diuretic Therapy: A Case Series of Six Patients - Summary - MDSpire
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Sodium Thiosulfate as a Treatment for Persistent Metabolic Alkalosis Induced by Diuretics: A Case Series Involving Six Patients

  • September 1, 2026

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Objective:

To evaluate the effectiveness of sodium thiosulfate (STS) in treating refractory metabolic alkalosis induced by diuretics in patients requiring ongoing decongestion.

Approach:
  • Patient Selection: Six patients with diuretic-induced metabolic alkalosis and persistent hypervolemia were treated with STS after standard therapies failed.
  • Intervention: Each patient received intravenous STS, with doses of 25 g/100 mL, to induce metabolic acidosis and reduce serum bicarbonate levels.
Key Findings:
  • All patients showed a decrease in serum total carbon dioxide levels after STS treatment, with an average reduction of approximately 5 mmol/L per 25 g of STS.
  • No immediate adverse effects were observed following STS administration.
  • Patients maintained clinical congestion and required ongoing diuresis despite worsening alkalosis.
Limitations:
  • The study involved a small sample size of only six patients.
  • Long-term effects and safety of STS in this context remain unassessed.

Original Source(s)

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

  • September 1, 2026

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