INTRODUCTION
Mineral and bone disorders (CKD-MBD) are common chronic kidney disease
(CKD) complications associated with cardiovascular outcomes and
mortality in dialysis patients [1–5]. The spectrum of bone disease
in peritoneal dialysis (PD) patients is yet to be clarified; it has
recently been shown that up to 54% of patients with parathormone (PTH)
within the goal recommended by KDIGO [6] had histomorphometry
compatible with low bone turnover (LBT), according to Pereira et
al [7]. In this case, many abnormalities of calcium and phosphate
metabolism are described, mainly the presence of a positive calcium
balance, which may result in an over-suppression of PTH [8,9].
Moreover, without efficient phosphate binding therapy, all PD patients
have a positive phosphorus balance, witnessing continuous intrinsic
inflammation activity accompanied by calcium and phosphorus imbalance,
leading to extraosseous calcifications (EC), especially vascular
calcifications (VC), regardless of bone turnover [10]. As a result,
a reduction in serum calcium, phosphate and parathyroid levels control
are important to prevent EC, while a solution of sodium thiosulphate
(STS) has been used to treat a variety of metastatic calcifications
related to CKD-MBD, acting as a potent calcium chelator, antioxidant,
and vasodilator agent. Herein, we report a case of a young female CKD
patient on PD with adynamic bone disease (ABD) and brown tumour (BT),
who was successfully treated by intravenous STS, which was the
cornerstone treatment.