Successful treatment of valproic acid overdose with hemodialysis

L. Z. Johnson, I. Martinez, M. C. Fernandez, C. P. Davis, B. S. Kasinath

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

A 43-year-old woman took a large amount of depakote (divalproex, a slow- release form of valproate), became comatose, and developed severe hypotension refractory to fluid resuscitation and high-dose vasopressors. The serum valproic acid (VPA) concentration on admission was 1,380 μg/mL (therapeutic range, 50 to 100 μg/mL). She also had metabolic acidosis, thrombocytopenia, and normal renal and liver functions. Hemodialysis was initiated 4 hours after presentation. After 6 hours of hemodialysis with a high-flux dialyzer, her serum VPA concentration decreased from 940 μg/mL to 164 μg/mL, coincident with improvement in clinical status. The half-life of VPA was reduced to 2.4 hours with hemodialysis, whereas it was 7.2 hours before the procedure. Hemodialysis could be a valuable therapeutic intervention in VPA toxicity.

Original languageEnglish (US)
Pages (from-to)786-789
Number of pages4
JournalAmerican Journal of Kidney Diseases
Volume33
Issue number4
DOIs
StatePublished - 1999

Keywords

  • Coma
  • Hemodialysis
  • Overdose
  • Poisoning
  • Valproic acid

ASJC Scopus subject areas

  • Nephrology

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