Acute kidney injury, hyperosmolality and metabolic acidosis associated with lorazepam

Nature Clinical Practice Nephrology

Volumn 3, Issue 9, 2007, Pages 515-520

  Zar, Tausif ^a,b   Yusufzai, Irfan ^b   Sullivan, Anna ^c   Graeber, Charles ^b,c  

^a Division of Nephrology

^b UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE   (United States)

^c NEW BRITAIN GENERAL HOSPITAL   (United States)

Author keywords

acute kidney injury; Hyperosmolality; Lorazepam adverse effects; Metabolic acidosis; Propylene glycol toxicity

Indexed keywords

LORAZEPAM; PROPYLENE GLYCOL;

ADULT; ALCOHOL INTOXICATION; ANAMNESIS; ARTICLE; CASE REPORT; CLINICAL FEATURE; DRUG MEGADOSE; HUMAN; HYPEROSMOLALITY; KIDNEY INJURY; MALE; METABOLIC ACIDOSIS; PRIORITY JOURNAL;

ACIDOSIS; ALCOHOL WITHDRAWAL DELIRIUM; ANTI-ANXIETY AGENTS; DRUG COMPOUNDING; HUMANS; INFUSIONS, INTRAVENOUS; KIDNEY FAILURE, ACUTE; LORAZEPAM; MALE; MIDDLE AGED; OSMOLAR CONCENTRATION; PROPYLENE GLYCOL; RENAL DIALYSIS; VEHICLES;

EID: 34548146026     PISSN: 17458323     EISSN: 17458331     Source Type: Journal    
DOI: 10.1038/ncpneph0573     Document Type: Article

References (21)

1. Wilson KC et al. (2005) Propylene glycol toxicity: a severe iatrogenic illness in ICU patients receiving IV benzodiazepines: a case series and prospective, observational pilot study. Chest 128: 1674-1681
2. Arroliga AC et al. (2004) Relationship of continuous infusion lorazepam to serum propylene glycol concentration in critically ill adults. Crit Care Med 32: 1709-1714
3. Mullins ME and Barnes BJ (2002) Hyperosmolar metabolic acidosis and intravenous lorazepam. N Engl J Med 347: 857-858
4. Tayar J et al. (2002) Severe hyperosmolar metabolic acidosis due to a large dose of intravenous lorazepam. N Engl J Med 346: 1253-1254
5. Tuohy KA et al. (2003) Agitation by sedation. Lancet 361: 308
6. Yaucher NE et al. (2003) Propylene glycol-associated renal toxicity from lorazepam infusion. Pharmacotherapy 23: 1094-1099
7. Romanski SA and McMahon MM (1999) Metabolic acidosis and thiamine deficiency. Mayo Clic Proc 74: 259-263
8. Reynolds HN et al. (2000) Hyperlactatemia, increased osmolar gap and renal dysfunction during continuous lorazepam infusion. Crit Care Med 28: 1631-1634
9. Morshed KM et al. (1994) Acute toxicity of propylene glycol: an assessment using cultured proximal tubule cells of human origin. Toxicol Sci 23: 38-43
10. Hayman M et al. (2003) Acute tubular necrosis associated with propylene glycol from concomitant administration of intravenous lorazepam and trimethoprim-sulfamethoxazole. Pharmacotherapy 23: 1190-1194
11. Sturgill BC et al. (1982) Renal tubular necrosis in burn patients treated with topical polyethylene glycol [abstract]. Lab Invest 46: 81A
12. Yorgin PD et al. (1997) Propylene glycol-induced proximal renal tubular cell injury. Am J Kid Dis 30: 134-139
13. Yip L (2004) Other alcohols, glycols, and glycol ethers. In Medical Toxicology, edn 3 1237-1239 (Eds Dart RC et al.) Philadelphia: Lippincott Williams & Wilkins
14. Neale BW et al. (2005) Propylene glycol-induced lactic acidosis in a patient with normal renal function: a proposed mechanism and monitoring recommendations. Ann Pharmacother 39: 1732-1735
15. Jorens PG et al. (2004) Unusual D-lactic acid acidosis from propylene glycol metabolism in overdose. J Toxicol Clin Toxicol 42: 163-169
16. Chicella M et al. (2002) Propylene glycol accumulation associated with continuous infusion of lorazepam in pediatric intensive care patients. Crit Care Med 30: 2752-2756
17. Cawley MJ (2001) Short-term lorazepam infusion and concern for propylene glycol toxicity: case report and review. Pharmacotherapy 21: 1140-1144
18. Barnes BJ et al. (2006) Osmolal gap as a surrogate marker for serum propylene glycol concentrations in patients receiving lorazepam for sedation. Pharmacotherapy 26: 23-33
19. Brooks DE and Wallace KL (2002) Acute propylene glycol ingestion. J Toxicol Clin Toxicol 40: 513-516
20. Parker MG et al. (2002) Removal of propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy. Intensive Care Med 28: 81-84
21. Al-Khafaji AH et al. (2002) Propylene glycol toxicity associated with lorazepam infusion in a patient receiving continuous veno-venous hemofiltration with dialysis. Anesth Analg 94:1583-1585