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  • Title: Acute kidney injury, hyperosmolality and metabolic acidosis associated with lorazepam.
    Author: Zar T, Yusufzai I, Sullivan A, Graeber C.
    Journal: Nat Clin Pract Nephrol; 2007 Sep; 3(9):515-20. PubMed ID: 17717564.
    Abstract:
    BACKGROUND: A 54-year-old male with a history of multiple admissions for alcohol intoxication was admitted to hospital with right flank pain. He received a high-dose lorazepam infusion for alcohol withdrawal during hospitalization and developed severe hyperosmolality, high anion gap metabolic acidosis, and acute kidney injury on his eighth day of hospitalization. INVESTIGATIONS: Serum chemistries, arterial blood gas analysis, and measurement of serum propylene glycol, ethylene glycol and methanol levels. DIAGNOSIS: Propylene glycol toxicity. MANAGEMENT: Discontinuation of lorazepam infusion, administration of fomepizole, hemodialysis for five consecutive days, hemodynamic support, and follow-up of serum osmolality as a measure of propylene glycol decay.
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