{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:11:19Z","timestamp":1784146279599,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Extracorporeal therapies could be required for treatment of life\u2010threatening severe acute intoxication. We present the case of an 82\u2010year\u2010old patient admitted to our Nephrology Unit because of metformin\u2010associated lactic acidosis (MALA) and acute kidney injury (AKI stage III AKIN criteria). The patient also presented severe intoxication of digoxin and apixaban. The electrocardiogram presented a junctional escape rhythm with atrial fibrillation (AF) and lateral ST\u2010segment depression that, despite fab\u2010fragments' administration, has not regress. Due to patient's hemodynamic instability, an 8\u2009h of sustained low\u2010efficiency diafiltration (SLED) was prescribed. This treatment allowed to reduce serum concentration of apixaban and digoxin. Similarly, patient's hemodynamic and ECG trace improved with the resolution of junctional rhythm and persistence of AF. Even if continuous renal replacement therapy (CRRT) is the first choice in critical ill patients, SLED could represent a valid option for patients without indication to ICU.<\/jats:p>","DOI":"10.1111\/sdi.13233","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T07:03:24Z","timestamp":1734419004000},"page":"152-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Simultaneous Treatment of Two Severe Acute Intoxication and Acute Kidney Injury"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-2195","authenticated-orcid":false,"given":"Fulvia","family":"Zappulo","sequence":"first","affiliation":[{"name":"Nephrology, Dialysis and Kidney Transplant Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Martano","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Ullo","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Kidney Transplant Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Catalano","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Donini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 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