Dialysis treatment of acute chromium intoxication and comparative efficacy of peritoneal versus hemodialysis in chromium removal.

External burns with chromic acid have been fatal even in cases with corrosions covering less than 10% of the body surface area. We observed a 19-year-old man with third-degree burns and chromium intoxication following accidental contact of both legs with chromium acid solution. The initial course was characterized by serum chromium levels known to be usually lethal (220 micrograms/100 ml), complete anuria, hepatic damage and progressive anemia. Aggressive peritoneal dialysis with a total duration of 252 h between the 4th and 22nd day after exposure caused a progressive decrease in serum chromium levels and resulted in a complete recovery after 35 days. The comparative efficacy of peritoneal versus hemodialysis in chromium removal was evaluated in 5 patients with acute renal failure who were treated with peritoneal dialysis and in 6 patients with end-stage renal failure who underwent hemodialysis. Following intravenous injection of 500 muCi51CrCl3 chromium clearance averaged 0.8 +/- 0.3 ml/min and 2.5 +/- 0.8 ml/min during peritoneal dialysis (n = 50) or hemodialysis (n = 24), respectively. It is concluded that hemodialysis is about 3 times as effective as peritoneal dialysis in chromium removal per unit of time. However, the possibility of applying uninterrupted peritoneal dialysis during the first few days suggests that this method is at least equivalent to hemodialysis for treatment in the initial stage of chromium intoxication.