Acute Kidney Injury Associated with Rapid Treatment of Hemodiafiltration for Bismuth Intoxication: Update and Review of the Literature
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Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Abstract: On altı yaşında kız hasta bulantı ve kusma yakınmaları ile acil servisimize başvurdu. Öyküsünden, gün önce intihar amaçlı 35 adet De-Nol tablet (10,5 gr kolloidal bizmut subsitrat) aldığı öğrenildi. Başvuru anındaki fizik muayene bulguları normal olarak değerlendirildi. Laboratuar tetkiklerinde; BUN 76 mg/dl, kreatinin 19.2 mg/dl ve serum bizmut düzeyi 395 pg/lt idi. Hastaya sıvı ve elektrolit tedavisi, hemodiyaliz tedavisi ve şelatör ajan olarak penisilamin tedavileri başlandı. Daha sonra, 72 saat süreyle sürekli venö--venöz hemodiyafiltrasyon tedavisi uygulandı. Üç günlük hemodiyafiltrasyon tedavisi sonunda BUN: 14 mg/dl ve serum kreatinin düzeyi 0.78 mg/dl'ye geriledi. Penisilamin tedavisinin 14. gününde serum bizmut düzeyi 32 ug/L'ye düştü. Bu vaka; kolloidal bizmut subsitrat intoksikasyonu sonucu gelişen akut böbrek hasarının tedavisinde hemodiyaliz yan etkileri gözlendiğinde hemodiyafiltrasyonun alternatif bir tedavi yöntemi olabileceğini göstermiştir.
Abstract: 16-years-old girl admitted to our emergency unit with complaints of nausea and vomiting. From her history, we learned that she had ingested 35 tablets (10.5 9) of colloidal bismuth subcitrate (CBS) (De--Nol) in suicidal attempt days ago. On admission, her physical examination findings were unremarkable. Her laboratory findings were blood urea nitrogen (BUN) 76.0 mg/dl, serum creatinine (Cr) was 19.2 mg/dl and serum bismuth level was 395 ug/L. lntravenous fluid and electrolytes, hemodialysis (HD) and penicillamine as chelator agent was initiated. Then, continuous veno-venous hemodiafiltration (CWHDF) was performed during 72 hours. On the 3rd day the CVVHDF treatment BUN and Cr values decreased to 14 mg/dl and 0.78 mg/dl, respectively. This case report showed that CWHDF can be an alternative therapy for acute kidney injury due to CBS intoxication when complications observed in HD.
Abstract: 16-years-old girl admitted to our emergency unit with complaints of nausea and vomiting. From her history, we learned that she had ingested 35 tablets (10.5 9) of colloidal bismuth subcitrate (CBS) (De--Nol) in suicidal attempt days ago. On admission, her physical examination findings were unremarkable. Her laboratory findings were blood urea nitrogen (BUN) 76.0 mg/dl, serum creatinine (Cr) was 19.2 mg/dl and serum bismuth level was 395 ug/L. lntravenous fluid and electrolytes, hemodialysis (HD) and penicillamine as chelator agent was initiated. Then, continuous veno-venous hemodiafiltration (CWHDF) was performed during 72 hours. On the 3rd day the CVVHDF treatment BUN and Cr values decreased to 14 mg/dl and 0.78 mg/dl, respectively. This case report showed that CWHDF can be an alternative therapy for acute kidney injury due to CBS intoxication when complications observed in HD.
Açıklama
Anahtar Kelimeler
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
4
Künye
ELMAS A. T,TABEL Y (2013). Acute Kidney Injury Associated with Rapid Treatment of Hemodiafiltration for Bismuth Intoxication: Update and Review of the Literature. İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi, 20(4), 344 - 347.
