In-vivo and In-vitro hemodialysis studies of thiocyanate

Abstract

Dialysis clearance of thiocyanate was studied using in-vivo and in-vitro systems. The in-vivo studies were performed in a patient with renal failure receiving sodium nitroprusside infusion for accelerated hypertension. In-vitro studies were carried out under experimental conditions similar to those of the in-vivo experiment. Plasma thiocyanate level consistently fell with single passage through the dialyzer. In-vivo dialysance of thiocyanate averaged 82.8 ml/min as compared to urea dialysance of 129.6 ml/min. The in-vitro studies revealed an average thiocyanate dialysance of 102.3 as compared to a urea dialysance of 138.6 ml/min. Removal of thiocyanate by hemodialysis was further verified by recovery of significant amounts of thiocyanate in the outgoing dialysate. The thiocyanate clearance calculated directly from the amount recovered in the dialysate and mean plasma concentration was 82.2 ml/min, a value closely approximating that obtained using the transdialyzer concentration gradient. We conclude that hemodialysis is effective in removing thiocyanate and can be used as adjunct in the treatment of thiocyanate toxicity particularly in the presence of renal failure in which thiocyanate excretion is impaired.