Early continuous dialysis in acute glyphosate-surfactant poisoning

Abstract

Introduction. Treating severe acute glyphosate-surfactant poisoning requires intensive therapy including dialysis. Cases of hemoperfusion and hemodialysis use in renal failure induced by herbicide ingestion have been reported in the current medical literature. We present a case report of successful patient treatment with continuous venovenous hemodiafiltration in acute glyphosate-surfactant poisoning. Case Outline. A 36-year-old male patient attempted suicide by drinking approximately 300 ml of glyphosate-surfactant about an hour before coming to our Clinic. On admittance the patient was somnolent, normotensive, acidotic and hyperkalemic. Six hours after poison ingestion there was no positive response to symptomatic and supportive therapy measures. The patient became hypotensive, hypoxic with oliguric acute renal failure, so that post-dilution continuous veno-venous hemodiafiltration was started. During the treatment the patient became hemodinamically stabile, diuresis was established along with electrolyte and acid-base status correction and a gradual decrease of blood urea nitrogen and creatinine levels. After a single 27.5-hour treatment, clinical condition and renal function parameters did not require further dialysis. Complete recovery of renal function was achieved on the fifth day. Conclusion. Early introduction of continuous veno-venous hemodiafiltration with other intensive therapy measures led to complete recovery in a hemodinamically instable patient.

Keywords

• acute poisoning
• glyphosate
• herbicides
• hemodialysis
• continuous dialysis
• hemodiafiltration