title: Acute kidney injury, hyperosmolality and metabolic acidosis associated with lorazepam.
abstract: BACKGROUND
  A 54-year-old male with a history of multiple admissions for alcohol intoxication was admitted to hospital with right flank pain. He received a high-dose lorazepam infusion for alcohol withdrawal during hospitalization and developed severe hyperosmolality, high anion gap metabolic acidosis, and acute kidney injury on his eighth day of hospitalization.
  
  
  METHODS
  Serum chemistries, arterial blood gas analysis, and measurement of serum propylene glycol, ethylene glycol and methanol levels.
  
  
  METHODS
  Propylene glycol toxicity.
  
  
  RESULTS
  Discontinuation of lorazepam infusion, administration of fomepizole, hemodialysis for five consecutive days, hemodynamic support, and follow-up of serum osmolality as a measure of propylene glycol decay.
authors: Division of Nephrology, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA. zarjr73@yahoo.com
authors: Tausif
authors: T
authors: Zar
authors: Irfan
authors: I
authors: Yusufzai
authors: Anna
authors: A
authors: Sullivan
authors: Charles
authors: C
authors: Graeber
mesh_terms: D000138:Acidosis / Q000139:chemically induced; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004339:Drug Compounding; D006801:Humans; D007262:Infusions, Intravenous; D008140:Lorazepam / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D014677:Pharmaceutical Vehicles / Q000009:adverse effects* / Q000493:pharmacokinetics; D019946:Propylene Glycol / Q000009:adverse effects* / Q000493:pharmacokinetics; D006435:Renal Dialysis
chemical_list: D014151:Anti-Anxiety Agents; D014677:Pharmaceutical Vehicles; D019946:Propylene Glycol; D008140:Lorazepam