Polyurethane foam pica in a patient with excessive interdialytic weight gain

Maintaining fluid balance in haemodialysis patients is important because of the adverse effects of excessive interdialytic weight gain. This often requires fluid restriction that patients often struggle with. We report a case of a 31-year-old female diabetic patient on haemodialysis with repeated excessive interdialytic weight gains despite fluid restriction and dry weight adjustment. It was subsequently discovered that she devised an unusual, albeit unsuccessful, strategy of eating the polyurethane foam from her dialysis chair while increasing her fluid intake hoping that it would absorb excess water in the gut! This under-diagnosed phenomenon known as pica has been reported in renal patients with substances such as ice, clay and baking soda.