Hemoperfusion for Treatment of N-Acetylprocainamide Intoxication

Excerpt

The pharmacokinetics of procainamide and its major metabolite, N-acetylprocainamide, are significantly altered in patients with chronic renal failure (1-4). Because N-acetylprocainamide is normally eliminated through renal excretion, it tends to accumulate in patients with renal failure and may reach toxic levels in patients on chronic dialysis despite adequate dialytic therapy (1-4). In addition, recent reports of N-acetylprocainamide intoxication in dialysis patients have shown that therapy either by peritoneal dialysis (5) or hemodialysis (6) is of questionable benefit. We report the case of a patient on chronic hemodialysis who developed N-acetylprocainamide intoxication and show the superiority of hemoperfusion over hemodialysis in