Severe Ethylene Glycol Toxicity: Multidisciplinary Management and Long-Term Renal Implications

Ethylene glycol (C₂H₆O₂), a toxic alcohol commonly found in automotive antifreeze, de-icing solutions, and industrial coolants, can cause severe toxicity when ingested. Due to its sweet taste, it is often consumed accidentally or intentionally, leading to life-threatening consequences such as metabolic acidosis, acute kidney injury (AKI), and mortality. Prompt diagnosis and early treatment with antidotes such as fomepizole or ethanol, combined with hemodialysis, are essential in preventing severe outcomes. This report discusses the case of a 60-year-old male with a history of alcohol use disorder who presented with suspected ethylene glycol poisoning, confirmed by elevated serum levels (513 mg/dL). He received aggressive treatment including fomepizole and multiple hemodialysis sessions, which improved his acid-base status and renal function. Despite initial recovery, survivors of ethylene glycol poisoning remain at risk for developing chronic kidney disease (CKD). Prognostic factors such as severe metabolic acidosis, hyperkalemia, and neurological symptoms influence outcomes including developing CKD, with early intervention improving prognosis. This case emphasizes the importance of diagnosing ethylene glycol poisoning and initiating timely treatment to optimize outcomes and reduce long-term renal complications. Long-term follow-up is crucial for monitoring kidney function, as AKI survivors remain at higher risk for progressive renal decline.