ACUTE-RENAL-FAILURE IN A CASE OF BISMUTH INTOXICATION

We report the case of a 21-years-old woman, who had ingested 100 tablets of a bismuthsubcitrate containing compound. In the course of a few days an acute renal failure requiring passagerily an hemodialysis treatment developed. The first dialysis was combined with an hemoperfusion. In addition a plasmaseparation was carried out in order to eliminate bismuth. There was a monitoring of bismuth levels in serum and urine over 6 weeks and a rapid fall of bismuth levels in serum and urine. The calculated clearance for the elimination of bismuth under hemodialysis treatment was 109 ml/min. The acute renal failure proved to be reversible. The clearance studies carried out after normalisation of urea and creatinine showed a reduction of glomerular filtration rate as well as of renal plasma flow. Histology showed tubular degeneration as well as interstitial fibrosis. Intranuclear or cytoplasmatic bodies could not be demonstrated at this time.