Estimated total duration of hemodialysis for methanol or ethylene glycol poisoning

Pre-dialysis methanol concentration		Pre-dialysis ethylene glycol concentration		Estimated total hemodialysis duration
(mg/dL)	(mmol/L)^*	(mg/dL)	(mmol/L)^*	(hours)
50	16	50	8	3
90	28	90	15	5
160	50	160	26	7
300	94	300	48	9

This table is an approximation based on a 60-year-old male, height 180 cm, weight 70 kg, with post-dialysis target concentration of 20 mg/dL (methanol 6.2 mmol/L; ethylene glycol 3.2 mmol/L) and dialyzer urea clearance of 250 mL/min. Refer to UpToDate content for formula to calculate required hemodialysis time more precisely. Under the scenario provided (ie, patient size and dialyzer urea clearance), the toxic alcohol concentration decreases by one-half approximately every 2.3 hours. The target concentration of 20 mg/dL may not be achievable with a single course of hemodialysis.

* If the toxic alcohol serum concentration is unavailable, the increase in osmolal gap can be used to estimate the concentration (ie, an increase of ~10 mOsm/kg for every 10 mmol/L of methanol or ethylene glycol) and thus duration of hemodialysis. Refer to UpToDate table on Estimating toxic alcohol concentration in mg/dL from increase in osmolal gap.

References:

Youssef GM, Hirsch DJ. Validation of a method to predict required dialysis time for cases of methanol and ethylene glycol poisoning. Am J Kidney Dis 2005; 46:509.
McMurray M, Carty D, Toffelmire EB. Predicting methanol clearance during hemodialysis when direct measurement is not available. CANNT J 2002; 12:29.

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Estimated total duration of hemodialysis for methanol or ethylene glycol poisoning