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April 15, 1968

Peritoneal Dialysis In Quinine Intoxication

Author Affiliations

USA; USA; USA; USA; Washington, DC

JAMA. 1968;204(3):274. doi:10.1001/jama.1968.03140160084037

To the Editor:—  Our experience with removal of quinine by peritoneal dialysis and mannitol-enhanced urinary excretion of quinine is remarkably different from the observations of Markham et al (202:1102, 1967). Removal of quinine by peritoneal dialysis (Table 1) compares our four patients with Plasmodium falciparum malaria complicated by acute renal failure with Markham's patient.Even at plasma quinine concentrations which were generally higher than in Markham's patient, the total removal of quinine and removal rate of quinine by peritoneal dialysis in our patients was trivial. In 56 peritoneal-clearance periods, quinine clearance was remarkably low, varying from 1 ml to 8 ml/min. Peritoneal clearances (C=UV)/P were calculated with total outflow volume (V), aliquots of each pooled outflow volume for quinine determinations (U), and mid-clearance blood samples (P). Clearance periods, which were timed from commencement of inflow to completion of outflow, were approximately 60 minutes in duration. The poor peritoneal clearance