Roundup intoxication and a rationale for treatment

A 51-year-old man with no history ofrenal disease was admitted to our hospital after an intentional ingestion of Roundup, a glyphosate-based herbicide. His course was significant for the development of acute renal failure with oliguria and severe hypoxia. Although efficacy data are sparse and controversial, we proceeded with hemodialysis in an effort to correct his worsening volume status and to potentially clear toxins that are normally excreted by the kidney. His condition improved immediately and his renal function returned to normal over the course of several weeks. We argue that hemodialysis in the setting of such herbicide ingestions may facilitate significant intoxicant clearance, especially in the setting of impaired glomerular filtration. We also make recommendations regarding possible toxin-related sequelae that may warrant initiation of hemodialysis therapy.