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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
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BMC Nephrology

ISSN: 1471-2369

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