Acute Neurotoxicity and Hyperlactatemia Due To Hemodialysis Water System Contamination: a New Relationship

Abstract

Objectives: Many acute complications may develop in hemodialysis (HD) patients. Among these, life-threatening poi- soning due to HD water system contamination has an important place. In this study, we aimed to investigate the rela- tionship between acute neurotoxicity and hyperlactatemia, which developed after HD in HD patients. Methods: This retrospective study includes intoxication cases treated in two tertiary centers. The laboratory and clini- cal parameters, treatments and outcomes of the patients were recorded during their hospitalization. Results: A total of 15 patients were included in the study. Almost all patients had headache, dizziness, and nausea. The mean lactate was 23.7±5 mmol/L. All patients underwent a mean of 5.6±0.8 HD session. Dimercaprol, a heavy metal chelator, was administered to one patient due to its severe clinical course. The same patient died on the 8th day of hospitalization. Other patients' neurotoxicity findings were mostly resolved. Conclusion: HD patients have a high risk of heavy metal toxicity due to direct blood contact. We report the association of neurotoxicity and hyperlactatemia for the first time in this patient group.