Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. Toxic effects include hyperosmolality, increased anion gap metabolic acidosis (due to lactic acidosis), acute kidney injury, and sepsis-like syndrome. Treatment of toxicity includes hemodialysis to effectively remove propylene glycol. Prevention is best achieved by limiting the dose of propylene glycol infused.

We measured dialysate protein losses from polysulphone dialyzers undergoing repetitive processing with bleach and formaldehyde. The entire dialysate was collected during the first, fifth and tenth use of F-80 dialyzers. Dialysate protein concentration was 1.5 +/- 0.4 mg/dl N = 11 +/- SEM) during the first use, 2.1 +/- 0.3 mg/dl during the fifth use and 3.6 +/- 0.5 mg/dl (N = 10) during the tenth use. In a follow-up study, dialyzers were evaluated for up to 25 uses. After 12 to 15 uses dialysate protein was 7.9 +/- 0.8 mg/dl (N = 13), after 16 to 20 uses; 12.0 +/- 1.2 mg/dl (N = 13) and after 23 to 25 uses; 19.9 +/- 2.1 mg/dl (N = 5). Mean dialysate volume was 83.9 +/- 1.1 liters (N = 63) yielding total protein losses of up to 20.7 grams per treatment. Dialysate albumin losses, which were unmeasurable during the first use of the dialyzers, revealed a similar increase with reuse resulting in a mean value of 14.4 +/- 3.2 mg/dl after 23 to 25 reuses (N = 5). Dialysate beta-2 microglobulin (beta 2m) levels were 1.05 +/- 0.13 mg/l for dialyzers bleached < 10 times (N = 32) versus 1.54 +/- 0.15 mg/liter for dialyzers bleached > 10 times (N = 31, P < 0.02 vs. < 10 reuses). A random sampling of dialyzers processed without bleach for 8, 14, 15, 24 and 25 reuses revealed minimal protein losses, ranging from 1.4 to 2.7 mg/dl with no relation to reuse number and no measureable albumin.(ABSTRACT TRUNCATED AT 250 WORDS)

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