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Table 2 Extracorporeal removal of lead by different modes of extracorporeal blood purification in patients with acute or chronic lead intoxication after an initial administration of intravenous 500 mg to 1000 mg of CaNa2EDTA

From: Treatment of lead and arsenic poisoning in anuric patients – a case report and narrative review of the literature

Patients

Renal Function

Mode of Dialytic Therapy

Initial Blood Pb Level

Post-dialysis Blood Pb Level

Dialytic Pb Removal

Urinary Pb Excretion

Outcome

1 – Smith [37]

Normal

HD - 2 h

3.1 mg/g

1.0 mg/g

3.4 mg

n/a

Died

2

Normal

HD - 2 h

2.7 mg/g

1.3 mg/g

3.0 mg

n/a

Improved encephalopathy

3

Normal

HD - 30 min

1.6 mg/g

1.1 mg/g

1.0 mg

n/a

Remained severely encephalopathic

4

Normal

HD - 2 h

1.8 mg/g

0.7 mg/g

2.2 mg

n/a

Died

1 – Mehbod [38]

GFR < 10

CAPD

n/a

n/a

16.9 mg/20 h

0.12 mg/20 h

Weakness; constipation and anaemia improved

2

Normal

CAPD

n/a

n/a

1.90 mg/20 h

0.50 mg/20 h

No immediate improvement; no long-term follow up

3

Normal

CAPD

n/a

n/a

1.48 mg/20 h

0.70 mg/20 h

No immediate improvement; no long-term follow up

4

Normal

CAPD

1.25 mg/L

0.75 mg/L

2.00 mg/20 h

0.40 mg/20 h

Improved encephalopathy; no long-term follow up

1 – Pedersen [39]

Normal

HD – 9 h

1.36 mg/L

0.68 mg/L

n/a

n/a

Serum Pb level 0.28 mg/L after 7 weeks; no clinical outcome reported

1 – Roger [40]

ESKF

CAPD

1.40 μmol/L

n/a

9.29 μmol over 4 days

2.96 μmol/day on day 4

Improved mental state but peripheral neuropathy progressed after 4 months

1 – Kessler [41]

ESKF

HF

0.279 mg/L

n/a

1.650 mg/day a

n/a

2

ESKF

HF

0.131 mg/L

n/a

1.450 mg/day a

n/a

3

ESKF

HF

0.361 mg/L

n/a

1.152 mg/day a

Died

4

ESKF

HF

0.281 mg/L

n/a

1.267 mg/day a

n/a

5

ESKF

CAPD

0.265 mg/L

n/a

0.334 mg/day

0.476 mg/day

n/a

1 – Kessler [42]

ESKF

HF

0.280 mg/L

n/a

3.300 mg/day a

n/a

2

ESKF

CAPD

0.265 mg/L

n/a

0.710 mg/day a

n/a

1 – Barats [43]

ESKF

HD

0.690 mg/L

0.110 mg/Lb

n/a

n/a

Resolved encephalopathy and motor neuropathy

1 – Roberts [44]

ESKF

HD

0.49 μg/L

n/a

0.24 mg

0.025 mg

Lead mobilisation test

  1. ESKF end-stage kidney failure, GFR glomerular filtration rate, HD haemodialysis, HF haemofiltration, CAPD continuous ambulatory peritoneal dialysis, Pb lead
  2. a: combined urinary removal of lead over 24 h and dialysis; b: 3 months after chelation; n/a: not available