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Nephrol Dial Transplant (1999) 14: 2484-2486
© 1999 European Renal Association-European Dialysis and Transplant Association

Case Reports

Survival of a human immunodeficiency patient with nucleoside-induced lactic acidosis—role of haemodialysis treatment

Rochelle Chodock1, Eleftherios Mylonakis1,2, Douglas Shemin1,3, Valgerdur Runarsdottir2, Paul Yodice1,2, Richard Renzi1,2, Karen Tashima1,2, Christopher Towe2 and Josiah D. Rich1,2

1 Brown University School of Medicine, 2 The Miriam Hospital, Brown University School of Medicine and 3 Rhode Island Hospital, Division of Renal Diseases, Providence, Rhode Island

Correspondence and offprint requests to: Josiah D. Rich, MD, MPH, Department of Medicine, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA.

Keywords: AIDS; haemodialysis; HIV; lactic acidosis; nucleoside analogue



   Introduction
 
Combination antiretroviral therapy has become standard of care for treatment of human immunodeficiency virus (HIV) infection [1].The most commonly utilized regimens involve dual nucleoside analogues in combination with a protease inhibitor. A syndrome of lactic acidosis with fatty infiltration of the liver has been reported with the use of nucleoside analogues, and especially zidovudine [2]. The outcome for patients with this syndrome, as reported in the literature, is usually fatal, despite discontinuation of the offending drug [3].We report the case of a woman who developed metabolic acidosis related to nucleoside analogue therapy and survived with the transient use of haemodialysis.



   Case
 
A 35-year-old woman was admitted to the hospital with complaints of diarrhoea for 3 weeks and 1 week of nausea and vomiting. She had been on various nucleoside reverse transcriptase inhibitors, which included zidovudine, lamivudine and stavudine, for 6 years prior to admission. Three . . . [Full Text of this Article]



   Discussion
 


   Conclusion
 


   Note added in proof
 


   Acknowledgments
 


   References
 

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