Bismuth intoxication resulting in acute kidney injury in a pregnant adolescent girl

Özet

Bismuth intoxication is a rare cause of acute kidney injury (AKI) and isusually reversible by appropriate therapeutic measures. We present here acase of an adolescent pregnant girl who developed AKI due to an overdoseof colloidal bismuth subcitrate (CBS, total amount of 6 g). She receivedparenteral chelating agent dimercaprol for 14 days. Continuous venovenoushemodiafiltration (CVVHD) with high-flux membrane was carried out in thefirst 3 days of chelating therapy and intermittent hemodialysis for 11 days,thereafter. The patient recovered clinically and was discharged after 21 days.She gave birth to a healthy term boy. At the last visit, the baby was 6 monthsold with normal growth and development as well as normal kidney functions.Neither deterioration in renal functions nor emergence of proteinuria wasrecorded in the patient during follow-up care after hospital discharge. In casesof AKI due to an overdose of CBS, treatment with dimercaprol combinedwith high flux hemodiafiltration and subsequently hemodialysis appears tobe both useful and safe for bismuth elimination.