{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:04:34Z","timestamp":1787029474785,"version":"build-2736575974"},"reference-count":7,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Extracorporeal therapies such as hemodialysis, continuous renal replacement therapy (CRRT) or therapeutic plasma exchange (TPE) are mainstay treatments for acute toxins, venoms and poisonings. Ibuprofen is a common drug implicated in acute toxicity, with a major complication being acute kidney injury (AKI). As such, these patients often receive hemodialysis or CRRT, which do not remove substances with high protein binding (&gt;80%) and low volumes of distribution (Vd) (&lt;0.2 L\/kg). The pharmacokinetics of ibuprofen have these characteristics. While hemodialysis or CRRT can clear the accumulated toxic metabolites, they do not remove the ibuprofen that causes renal injury. In contrast, TPE can remove protein-bound drugs such as ibuprofen. Case Presentation: We describe the case of a previously healthy young male who presented with AKI due to ibuprofen toxicity requiring concurrent continuous renal replacement therapy and plasma exchange. Conclusions: TPE in conjunction with hemodialysis or CRRT is an effective treatment modality for ibuprofen toxicity.<\/jats:p>","DOI":"10.3390\/reports9030228","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:34:23Z","timestamp":1784172863000},"page":"228","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Plasma Exchange in the Setting of Acute Ibuprofen Poisoning: A Case and Review of the Literature"],"prefix":"10.3390","volume":"9","author":[{"given":"Raeshun T.","family":"Glover","sequence":"first","affiliation":[{"name":"Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5424-5519","authenticated-orcid":false,"given":"Robert W.","family":"Maitta","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4997-3412","authenticated-orcid":false,"given":"Yi-Yuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.2215\/CJN.02560319","article-title":"Extracorporeal removal of poisons and toxins","volume":"14","author":"King","year":"2019","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/jca.22043","article-title":"Guidelines on the Use of Therapeutic Apheresis in Clinical Practice\u2014Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue","volume":"38","author":"Alquist","year":"2023","journal-title":"J. Clin. Apher."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1053\/j.ajkd.2022.10.017","article-title":"Therapeutic plasma Exchange: Core Curriculum 2023","volume":"81","author":"Cervantes","year":"2023","journal-title":"Am. J. Kidney Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Geith, S., Renner, B., Rabe, C., Stenzel, J., and Eyer, F. (2017). Ibuprofen plasma concentration profile in deliberate ibuprofen overdose with circulatory depression treated with therapeutic plasma exchange: A case report. BMC Pharmacol. Toxicol., 18.","DOI":"10.1186\/s40360-017-0187-9"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"203A","DOI":"10.1378\/chest.2261579","article-title":"Massive ibuprofen overdose treated with therapeutic plasma exchange","volume":"148","author":"Manning","year":"2015","journal-title":"Chest"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"gfaa142-P1104","DOI":"10.1093\/ndt\/gfaa142.P1104","article-title":"P1104 The role of therapeutic plasma exchange combined with hemodialysis in management of poisoning and intoxication","volume":"35","author":"VanSickle","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/FPC.0000000000000113","article-title":"PharmGKB summary: Ibuprofen pathways","volume":"25","author":"Mazaleuskaya","year":"2014","journal-title":"Pharmacogenet. Genom."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/228\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:10:23Z","timestamp":1784175023000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["reports9030228"],"URL":"https:\/\/doi.org\/10.3390\/reports9030228","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]}}}