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Case Reports
. 2024 Jul 31;16(7):e65838.
doi: 10.7759/cureus.65838. eCollection 2024 Jul.

Polyethylene Glycol Misuse Causing Acute Renal Failure and Metabolic Acidosis Requiring Dialysis: A Case Report

Timothy J Kolosionek  1 , Rena Y Jiang  1 , Mostafa M Meleis  1 , Natalie E Ebeling-Koning  2 , Ryan M Surmaitis  2
Affiliations
Case Reports

Polyethylene Glycol Misuse Causing Acute Renal Failure and Metabolic Acidosis Requiring Dialysis: A Case Report

Timothy J Kolosionek et al. Cureus. .

Abstract

Laxative misuse is a well-known occurrence, most often identified in patients struggling with eating disorders. Polyethylene glycol (PEG) 3350 is a readily available, well-tolerated osmotic laxative. High doses of PEG 3350 may cause gastrointestinal upset, diarrhea, dehydration, and electrolyte imbalance, although systemic toxicity is infrequently reported. This case report highlights the exceedingly rare metabolic derangements associated with profound levels of protracted PEG misuse. A 60-year-old female presented to the emergency department with altered mental status. She was found to have acute renal failure (ARF), anion gap metabolic acidosis (AGMA), and rhabdomyolysis secondary to excessive PEG 3350 use, requiring continuous renal replacement therapy (CRRT). Renal function improved after three days of CRRT, and no alternative causes beyond PEG ingestion were found to account for her mental status changes or metabolic anomalies. This report illustrates the importance of considering osmotic laxative misuse in the setting of pre-renal and intrinsic renal failure.

Keywords: acute renal failure; anion-gap metabolic acidosis; laxative misuse; osmotic laxative; polyethylene glycol.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Representative axial section of a normal CT scan of the head
CT: computed tomography
Figure 2
Figure 2. Representative coronal section of an abdominal CT scan showing fluid-filled large bowel loops (white arrow)
CT: computed tomography
See this image and copyright information in PMC

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