title: Prediction and validation of hemodialysis duration in acute methanol poisoning.
abstract: The duration of hemodialysis (HD) in methanol poisoning (MP) is dependent on the methanol concentration, the operational parameters used during HD, and the presence and severity of metabolic acidosis. However, methanol assays are not easily available, potentially leading to undue extension or premature termination of treatment. Here we provide a prediction model for the duration of high-efficiency HD in MP. In a retrospective cohort study, we identified 71 episodes of MP in 55 individuals who were treated with alcohol dehydrogenase inhibition and HD. Four patients had residual visual abnormality at discharge and only one patient died. In 46 unique episodes of MP with high-efficiency HD the mean methanol elimination half-life (T1/2) during HD was 108 min in women, significantly different from the 129 min in men. In a training set of 28 patients with MP, using the 90th percentile of gender-specific elimination T1/2 (147 min in men and 141 min in women) and a target methanol concentration of 4 mmol/l allowed all cases to reach a safe methanol of under 6 mmol/l. The prediction model was confirmed in a validation set of 18 patients with MP. High-efficiency HD time in hours can be estimated using 3.390 × (Ln (MCi/4)) for women and 3.534 × (Ln (MCi/4)) for men, where MCi is the initial methanol concentration in mmol/l, provided that metabolic acidosis is corrected.
authors.affiliation: Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.|Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lachance
authors.affiliation: Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.|Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Mac-Way
authors.affiliation: Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.|Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Desmeules
authors.affiliation: Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.|Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada.
authors.forename: Sacha A
authors.initials: SA
authors.lastname: De Serres
authors.affiliation: Plateforme de Recherche Clinique, CHU de Québec Research Center, Québec, QC, Canada.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Julien
authors.affiliation: Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.|Division of Biochemistry, Faculty of Medicine, Université Laval, Québec, QC, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Douville
authors.affiliation: Division of Nephrology, University of Montreal, Verdun Hospital, Montreal, QC, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Ghannoum
authors.affiliation: Service de Néphrologie, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada.|Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Agharazii
mesh_terms: D000138:Acidosis / Q000097:blood; D000328:Adult; D000426:Alcohol Dehydrogenase / Q000037:antagonists & inhibitors; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D000432:Methanol / Q000097:blood* / Q000506:poisoning*; D008875:Middle Aged; D008954:Models, Biological; D011041:Poisoning / Q000628:therapy; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
chemical_list: D004791:Enzyme Inhibitors; D000426:Alcohol Dehydrogenase; D000432:Methanol