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Case Report

Ann Med Res. 2013; 20(4): 344-347


Acute Kidney Injury Associated with Rapid Treatment of Hemodiafiltration for Bismuth Intoxication: Update and Review of the Literature

Ahmet Taner Elmas, Yılmaz Tabel

 

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Abstract


A 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 g) of colloidal bismuth subcitrate (CBS) (De-Nol) in a suicidal attempt 7 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 µg/L. Intravenous fluid and electrolytes, hemodialysis (HD) and penicillamine as a chelator agent was initiated. Then, continuous veno-venous hemodiafiltration (CVVHDF) 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 CVVHDF can be an alternative therapy for acute kidney injury due to CBS intoxication when complications observed in HD.

Key Words: Acute Kidney Injury; Children; Colloidal Bismuth Subcitrate; Hemodiafiltration.






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