Use of hemodialysis after ingestion of a mixture of acids containing hydrofluoric acid.
Hydrofluoric acid (HF) is a highly toxic poison that can be rapidly fatal. Death usually results from the many systemic effects of dissociated fluoride ions, including hypocalcemia, hypomagnesemia, hyperkalemia, and direct cardiotoxicity. A patient is described who accidentally ingested a hydrofluoric acid-containing substance and who likely benefited from hemodialysis. His fluoride level post-dialysis was reduced by approximately 70% from a level drawn three hours prior to the initiation of hemodialysis. However, the single treatment did not reduce the fluoride level to normal. A review of the pathophysiology of hydrofluoric acid intoxication and the outcomes of prior exposures suggests that hemodialysis could play a vital role in the management of poisonings with fluoride-containing substances. However, the initial hemodialysis treatment should be prolonged beyond the standard four-hour session.
University of South Florida, Division of Nephrology and Hypertension, Tampa, FL 33612, USA. antarshultz@hotmail.com
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M
Antar-Shultz
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SI
Rifkin
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C
McFarren
D005458:Fluoride Poisoning / Q000628:therapy; D005459:Fluorides / Q000652:urine; D006801:Humans; D006858:Hydrofluoric Acid / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D005459:Fluorides; D006858:Hydrofluoric Acid