Sodium Thiosulfate for Refractory Metabolic Alkalosis From Diuretic Therapy: A Case Series of Six Patients - Takeaways - 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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  • 1

    Sodium thiosulfate (STS) was used in six patients with diuretic-induced metabolic alkalosis after standard treatments failed.

  • 2

    All patients had persistent hypervolemia and required ongoing diuresis despite receiving loop and thiazide diuretics.

  • 3

    STS administration resulted in a decrease in serum total carbon dioxide levels, averaging approximately 5 mmol/L per 25 g dose.

  • 4

    No immediate adverse effects from STS were observed in any of the six patients during the treatment.

  • 5

    The study highlights the limitations of standard treatments for metabolic alkalosis in patients with impaired renal function.

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