UMEM Educational Pearls

The cornerstone treatment of poisoning is removal of the toxin from the patient. This can be accomplished before absorption into the body by decontamination methods (dermal or gastrointestinal) or after absorption by blocking metabolism of parent compound, displacing drugs from receptors, binding toxins with neutralizing agents (chelators, Fab fragments), or enhancing elimination by dialysis. Toxins that are ideal candidates for dialysis include substances that are low molecular weight, have low volume of distribution (stay in the blood stream), or low protein binding. Toxins most commonly treated with dialysis are:

  • Lithium
  • Salicyclates
  • Ethylene glycol
  • Methanol
  • Acetaminophen


Dialysis in the poisoned patient. Bayliss G. Hemodial Int.

2010 Apr;14(2):158-67.

Use of Hemodialysis and perfusion in poisoned patients. Holubeck SF. Hoffman RS. Kidney Int. 2008 Nov;74 (10):1327-34. 




Use of Hemodiaysis and hemoperfusion in poisoned patients.  Holubek WJ, Hoffman RS, et al. Kidney INt.2008 Nov;74(10):1327-34. doi: 10.1038/ki.2008.462. Epub 2008 Sep 17.