Samira Pourtaghi anvarian
, Mahdi Khodayari
, Hamid Tayyebi Khosroshahi, Afshin Gharekhani, Mohsen Amjadi, Hadi Hamishehkar
*
Abstract
Nephrolithiasis is the most prevalent of kidney diseases and is associated with high recurrent rates, and the preventive pharmacologic options are limited. Historically, sodium thiosulfate (STS) has been used for conditions like cyanide poisoning, vascular calcification, and nephrocalcinosis, thanks to its calcium-chelating, anti-inflammatory, and antioxidant effects. With established applications and some evidence of STS in managing calcium-based kidney stones, interest in this potential role is growing nephrolithiasis. This review aims to evaluate the efficacy of sodium thiosulfate in preventing or treating calcium-based kidney stones based on existing evidence in animal and human investigations. A comprehensive literature review was performed using the central electronic database to identify relevant animal and human studies that had been published. Studies evaluating STS in the context of nephrolithiasis were included and organized according to their design, population, and reported outcomes. Animal studies have shown mixed outcomes, with some suggesting reduced stone formation through crystal solubilization, oxidative stress reduction, and mitochondria-mediated effects. Research on humans has limitations, including being small-scale, methodologically diverse, and lacking clear conclusions. As a result, the clinical benefits of oral STS in calcium nephrolithiasis are uncertain and sometimes conflicting. However, the established effectiveness of STS in treating vascular calcification and nephrocalcinosis provides a solid basis for understanding its mechanisms and potential benefits. The evidence on oral STS for calcium-based nephrolithiasis is limited and inconsistent. However, the previous success in treating other calcification-related disorders advocates further investigation. Well-designed clinical trials are necessary to validate its efficacy, define appropriate dosing regimens, and determine its role in managing recurrent calcium kidney stones.