J Korean Med Sci.  2009 Jan;24(Suppl 1):S156-S160. 10.3346/jkms.2009.24.S1.S156.

Comparison between Kidney and Hemoperfusion for Paraquat Elimination

• Kang MS
• Gil HW
• Yang JO
• Lee EY
• Hong SY

• KMID: 1778156
• DOI: http://doi.org/10.3346/jkms.2009.24.S1.S156

Abstract

The mortality rate of acute paraquat (PQ) poisoning depends on the PQ concentration in the blood. It has been shown that the kidneys eliminate PQ effectively. However, early renal function deterioration is frequently observed in acute PQ intoxication. This study is designed to compare the efficacy of PQ elimination with hemoperfusion (HP) and kidneys, taking into account the functional deterioration of the kidneys. The amount of renal and HP excretion of PQ were measured during the procedure of HP in patients with acute PQ intoxication. The PQ clearance and the actual amount of PQ elimination by the HP cartridge during the HP procedure were 111+/-11 mL/min (range; 13.2-162.2 mL/min) and 251.4+/-506.3 mg (range; 4.6- 1,655.7) each. While, the renal clearance and actual amount of renal elimination of PQ was 79.8+/-56.0 mL/min (range; 9.7-177.0) and 75.4+/-73.6 mg (range; 4.9- 245.8). As the creatinine clearance decreased, the PQ elimination by HP was as effective as or more effective than the renal elimination. In conclusion, early HP must be provided for life saving treatment in patients with acute PQ intoxication.

Keyword

Paraquat Intoxication; Hemoperfusion; Renal Excretion of Paraquat

MeSH Terms

Adult
Aged
Creatinine/blood
Emergency Medicine/methods
Female
Hemoperfusion/*methods
Herbicides/*poisoning
Humans
Kidney/drug effects/physiology
Male
Middle Aged
Overdose/therapy
Paraquat/*poisoning
Renal Dialysis/*methods
Suicide

Figure

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  Fig. 1 Comparison between Kidney and HP elimination according to PQ concentration. Note that the intersection of the two lines from the renal and HP elimination equation was at 5.3 µg/mL. PQ, paraquat; HP, hemoperfusion.

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  Fig. 2 Comparison between Kidney and HP elimination according to the creatinine clearance. When renal function stays within the normal range, the renal PQ elimination rate is higher than or just as good as the HP. However, as the creatinine clearance decreases, the PQ elimination by HP was more effective than the renal elimination.

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