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 language | English (US) |
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Pages (from-to) | 786-789 |
Number of pages | 4 |
Journal | American Journal of Kidney Diseases |
Volume | 33 |
Issue number | 4 |
DOIs | |
State | Published - 1999 |
Keywords
- Coma
- Hemodialysis
- Overdose
- Poisoning
- Valproic acid
ASJC Scopus subject areas
- Nephrology