Intensified dialysis treatment of ethylene glycol intoxication

During a period of 10 years 18 men were treated for severe ethylene glycol (EG) intoxication. All patients received supportive measures and ethanol infusion. Hemodialysis (HD) was applied in 11 patients (Group I) whereas 7 patients, who exhibited more advanced toxicity symptoms, received peritoneal dialysis (PD) simultaneously with HD (Group II). Patients in Group II showed more advanced acidosis on admission than in Group I (Base excess -27.1 mmol/l versus -16.8 mmol/l, p < 0.0075). The results of treatment in these two groups of patients were compared. All patients in Group I survived and one patient in Group II died. The patients in Group II were discharged with higher serum creatinine and follow up time to improve renal function was longer than in Group I (252 versus 149 mumol/l, p < 0.015 and 23 versus 7.9 weeks, p < 0.05 respectively). No correlations were found between serum EG and grade of acidosis on admission or serum EG and subsequent increase of serum creatinine but acidosis on admission was highly correlated to the rise of serum creatinine after the 72 hours of observation time (p < 0.0001). It is concluded, that combined HD and PD treatment was beneficial in the presented patients as it corrected acidosis earlier and could eliminate EG and its toxic metabolites faster, improving prognosis.