Acidosis and coma after hemodialysis

Ethylene glycol poisoning is a rare yet potentially fatal illness seen most commonly in association with ingestion by alcoholics or in suicide attempts. It is characterized by an elevated anion gap metabolic acidosis, osmolal gap, calcium oxalate crystals in the urine, and a well-defined clinical pi...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology 1997-05, Vol.8 (5), p.853-856
Main Authors: TAYLOR, R, BOWER, J, SALEM, M. M
Format: Article
Language:English
Subjects:
Acidosis - chemically induced
Acidosis - etiology
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Coma - chemically induced
Coma - etiology
Dialysis Solutions - adverse effects
Dialysis Solutions - chemistry
Drug Contamination
Emergency and intensive care: renal failure. Dialysis management
Ethylene Glycol
Ethylene Glycols - analysis
Fatal Outcome
Female
Humans
Intensive care medicine
Medical sciences
Mental Health
Middle Aged
Renal Dialysis - adverse effects
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Summary:Ethylene glycol poisoning is a rare yet potentially fatal illness seen most commonly in association with ingestion by alcoholics or in suicide attempts. It is characterized by an elevated anion gap metabolic acidosis, osmolal gap, calcium oxalate crystals in the urine, and a well-defined clinical picture. Prompt treatment is crucial because effective intervention can prevent the neurologic, cardiac, pulmonary, and renal sequelae associated with ethylene glycol poisoning. Hemodialysis offers rapid clearance of ethylene glycol and its toxic metabolites. In this article, the case of a hemodialysis patient who suffered contamination of the dialysate solution with ethylene glycol, leading to altered mental status, coma, and severe anion gap metabolic acidosis, is reported. Despite prolonged dialysis and correction of the acidosis, the patient remained comatose and subsequently died.
ISSN:1046-6673
1533-3450
DOI:10.1681/ASN.V85853