title: [Case of concrete hardener poisoning complicated with acute renal failure treated by hemodialysis].
abstract: A 54-year-old man took approximately 180 mL of rapid-hardening cement (75% sodium silicate) with suicidal intent and was transferred to our department after at least 2 hours had elapsed from the time he took the poison. Milk, sodium alginate, and a proton pump inhibitor were administered to the patient, and intravenous fluid infusion in a large dose with antibiotics was started. Upper gastrointestinal endoscopy revealed lesions in the oral cavity, pharynx, esophagus, and stomach. The most severe lesions observed were in the greater curvature of the stomach body. Hemodialysis was performed because of persistent oliguria and worsening of the renal function parameters. The patient underwent 8 sessions of hemodialysis over a period of 11 days, after which the dialysis was stopped. The serum level of silicon was 25.1 microg/mL on admission and 9.2 microg/mL at the time of withdrawal from hemodialysis. The gastrointestinal mucosal lesions resolved completely in response to the treatment. There were no residual lesions except for some scarring in the greater curvature of the stomach. Although the serum levels of silicon decreased transiently following each hemodialysis session, they increased again on the following day. Based on the observations in this case, it was proposed that a serum silicon level of less than 10 microg/mL is unlikely to cause renal dysfunction.
authors.affiliation: Department of Critical Care Medicine, Iwate Medical University.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Makoto
authors.initials: M
authors.lastname: Onodera
authors.forename: Hisayasu
authors.initials: H
authors.lastname: Isono
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Endo
authors.forename: Takehito
authors.initials: T
authors.lastname: Yanbe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujita
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy*; D003252:Construction Materials / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D017640:Silicates / Q000506:poisoning*; D013406:Suicide, Attempted; D016896:Treatment Outcome