{
    "abstract": "Extracorporeal therapies could be required for treatment of life-threatening severe acute intoxication. We present the case of an 82-year-old patient admitted to our Nephrology Unit because of metformin-associated lactic acidosis (MALA) and acute kidney injury (AKI stage III AKIN criteria). The patient also presented severe intoxication of digoxin and apixaban. The electrocardiogram presented a junctional escape rhythm with atrial fibrillation (AF) and lateral ST-segment depression that, despite fab-fragments' administration, has not regress. Due to patient's hemodynamic instability, an 8\u2009h of sustained low-efficiency diafiltration (SLED) was prescribed. This treatment allowed to reduce serum concentration of apixaban and digoxin. Similarly, patient's hemodynamic and ECG trace improved with the resolution of junctional rhythm and persistence of AF. Even if continuous renal replacement therapy (CRRT) is the first choice in critical ill patients, SLED could represent a valid option for patients without indication to ICU.",
    "authors": [
        {
            "affiliation": "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Fulvia",
            "initials": "F",
            "lastname": "Zappulo"
        },
        {
            "affiliation": "Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy.",
            "firstname": "Laura",
            "initials": "L",
            "lastname": "Martano"
        },
        {
            "affiliation": "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Ines",
            "initials": "I",
            "lastname": "Ullo"
        },
        {
            "affiliation": "Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy.",
            "firstname": "Veronica",
            "initials": "V",
            "lastname": "Catalano"
        },
        {
            "affiliation": "Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy.",
            "firstname": "Sara",
            "initials": "S",
            "lastname": "Donini"
        },
        {
            "affiliation": "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Anna",
            "initials": "A",
            "lastname": "Scrivo"
        },
        {
            "affiliation": "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Anna Laura Croci",
            "initials": "ALC",
            "lastname": "Chiocchini"
        },
        {
            "affiliation": "Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy.",
            "firstname": "Gaetano",
            "initials": "G",
            "lastname": "La Manna"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 The Author(s). Seminars in Dialysis published by Wiley Periodicals LLC.",
    "doi": "10.1111/sdi.13233\n10.2215/CJN.0000000000000057\n10.1111/sdi.12228\n10.3109/15563650.2012.683436\n10.1111/sdi.12238\n10.1111/jcpt.13724\n10.3109/15563650.2015.1118488\n10.1016/j.etap.2020.103400\n10.1007/s40262-019-00775-z\n10.1007/s00134-018-5464-6\n10.1159/000500013\n10.1159/000510292\n10.1111/jcpt.13668",
    "journal": "Seminars in dialysis",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-12-17",
    "pubmed_id": "39686602\n37097121\n24697864\n22578059\n24697909\n35924306\n26795743\n32464466\n31089975\n30446798\n31039564\n32937619\n35537706",
    "results": null,
    "title": "Simultaneous Treatment of Two Severe Acute Intoxication and Acute Kidney Injury.",
    "xml": "<Element 'PubmedArticle' at 0x788504cd7f60>"
}