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Kidney Int. 2015 Nov;88(5):1170-7. doi: 10.1038/ki.2015.232. Epub 2015 Aug 5.

Prediction and validation of hemodialysis duration in acute methanol poisoning.

Author information

1
Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.
2
Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada.
3
Plateforme de Recherche Clinique, CHU de Québec Research Center, Québec, QC, Canada.
4
Division of Biochemistry, Faculty of Medicine, Université Laval, Québec, QC, Canada.
5
Division of Nephrology, University of Montreal, Verdun Hospital, Montreal, QC, Canada.

Abstract

The duration of hemodialysis (HD) in methanol poisoning (MP) is dependent on the methanol concentration, the operational parameters used during HD, and the presence and severity of metabolic acidosis. However, methanol assays are not easily available, potentially leading to undue extension or premature termination of treatment. Here we provide a prediction model for the duration of high-efficiency HD in MP. In a retrospective cohort study, we identified 71 episodes of MP in 55 individuals who were treated with alcohol dehydrogenase inhibition and HD. Four patients had residual visual abnormality at discharge and only one patient died. In 46 unique episodes of MP with high-efficiency HD the mean methanol elimination half-life (T1/2) during HD was 108 min in women, significantly different from the 129 min in men. In a training set of 28 patients with MP, using the 90th percentile of gender-specific elimination T1/2 (147 min in men and 141 min in women) and a target methanol concentration of 4 mmol/l allowed all cases to reach a safe methanol of under 6 mmol/l. The prediction model was confirmed in a validation set of 18 patients with MP. High-efficiency HD time in hours can be estimated using 3.390 × (Ln (MCi/4)) for women and 3.534 × (Ln (MCi/4)) for men, where MCi is the initial methanol concentration in mmol/l, provided that metabolic acidosis is corrected.

PMID:
26244924
PMCID:
PMC4653586
DOI:
10.1038/ki.2015.232
[Indexed for MEDLINE]
Free PMC Article

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