Toxicology Reports最新文献

{"title":"Assessment of heavy metal exposure and cancer risk in Addis Ababa: Trends, risk factors and demographic variations in urinary cadmium, lead and chromium levels","authors":"Tsigereda Assefa Alemayehu ,&nbsp;Andualem Mekonnen Hiruy ,&nbsp;Mehari Meles ,&nbsp;Belay Tefera ,&nbsp;Tadesse Alemu Terfie","doi":"10.1016/j.toxrep.2025.102122","DOIUrl":"10.1016/j.toxrep.2025.102122","url":null,"abstract":"<div><div>This study aims to assess the exposure levels of Pb, Cd, and Cr and evaluate trends in heavy metal exposure among the population of Addis Ababa. A cross-sectional study was conducted involving 417 participants randomly selected from the population. Spot urine and water samples, socio-demographic characteristics, and food consumption frequency were collected. Heavy metals were analyzed using microwave plasma-atomic emission spectroscopy. Metal exposure risk from drinking water was assessed. The median concentrations of urinary Pb, Cr, and Cd were 19.4865 µg/g creatinine, 55.65 µg/g creatinine, and below the detection limit (Bd), respectively. Female participants and individuals who consumed meat daily had the highest median concentration of Pb (p &lt; 0.005). Those who drank two or more cups of water daily had lower Pb (P &lt; 0.01). Females who consumed eggs daily and drank two or more cups of water had the highest concentration of Cd, ranking in the 75th percentile. The median Cr concentration was higher in underweight participants (BMI &lt; 18.5 kg/m²) at 88.41 µg/g creatinine and in overweight participants (BMI ≥ 25 kg/m²) at 66.49 µg/g creatinine compared to normal-weight participants, who had a median concentration of 48.44 µg/g creatinine (P &lt; 0.01). Three metals were detected in 14.4 % and two metals in 52.8 %, and their levels showed an increasing trend over 12 years. Health risk analysis revealed that the highest Cumulative Incremental Life Cancer Risk (CILCR) values were found in Kirkos (KR-10–1.9 ×10⁻³), Lideta (LI-10–2.33 ×10⁻³), and Nifas Silk (NS-11–2.46 ×10⁻³) districts, indicating a significant cancer risk associated with cumulative exposure.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102122"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative neurotoxicity of Bisphenol-A and aluminum chloride in adult zebrafish: Behavioral disruption and region-specific neuropathology under chronic exposure","authors":"Logeshwari B ,&nbsp;Srikanth Jeyabalan ,&nbsp;Gayathri Veeraraghavan ,&nbsp;Krishnaraj Kaliaperumal ,&nbsp;Chetan Ashok ,&nbsp;Naveen Kumar Rajasekaran ,&nbsp;Ling Shing Wong ,&nbsp;Vetriselvan Subramaniyan ,&nbsp;Mahendran Sekar","doi":"10.1016/j.toxrep.2025.102161","DOIUrl":"10.1016/j.toxrep.2025.102161","url":null,"abstract":"<div><div>The escalating environmental presence of neuroactive pollutants such as Bisphenol-A (BPA) and aluminum chloride (AlCl₃) raises critical concerns regarding their long-term effects on cognitive health. This study presents a comparative neurotoxicity model using adult zebrafish (<em>Danio rerio</em>) exposed to a 21-day static immersion protocol with environmentally relevant doses (2 and 4 mg/L). Neurobehavioral changes were assessed using the novel tank diving test (NTDT) and a color-based T-maze test, combined with detailed histopathological scoring. BPA induced markedly stronger neurobehavioral and neuropathological effects than AlCl₃. BPA exposure caused dose-dependent reductions in swim velocity and distance travelled, heightened anxiety-like behavior, and cognitive inflexibility with reduced exploratory transitions and spatial learning. Histology revealed extensive vacuolation, neuronal pyknosis, and perineural congestion in the telencephalic and diencephalic regions, confirming widespread neurodegeneration. In contrast, AlCl₃ produced moderate impairments, with neuropathology primarily confined to the cerebellum and thalamus. These differential effects suggest distinct mechanisms: BPA may disrupt synaptic plasticity and hypothalamic–pituitary–interrenal (HPI) axis signaling, whereas AlCl₃ likely involves mitochondrial dysfunction and tauopathy. By integrating behavioral phenotyping with region-specific neuropathology, this model highlights the translational relevance of adult zebrafish for regulatory toxicology and human health risk assessment of aquatic neurotoxicants.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102161"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-endpoint assessment of tunnel wash water and tyre-particle leachate in zebrafish larvae","authors":"Shubham Varshney ,&nbsp;Chinmayi Ramaghatta ,&nbsp;Prabhugouda Siriyappagouder ,&nbsp;Andy M. Booth ,&nbsp;Lisbet Sørensen ,&nbsp;Pål A. Olsvik","doi":"10.1016/j.toxrep.2025.102096","DOIUrl":"10.1016/j.toxrep.2025.102096","url":null,"abstract":"<div><div>Washing of road tunnels is essential for removing accumulated pollutants such as tyre wear particles, brake dust, exhaust residues, and road debris to ensure visibility and safe driving. Tunnel washing generates large volumes of contaminated runoff known as untreated tunnel wash runoff (UTWR). Some countries filter UTWR through a sedimentation process before release to reduce contamination, generating what is known as treated tunnel wash runoff (TWR). This study investigates the potential environmental impact of diluted UTWR (25 %) and TWR (50 %) by evaluating their toxicity in fish and comparing the effect to tyre-particle leachate (TPL, 2 g/L). UTWR was collected during tunnel cleaning, and TWR was collected after 14 days of filtration through sand sediments, from the Bodø tunnel in Norway. Zebrafish larvae, used as a fish model, exposed to contaminated runoff exhibited increased mortality, impaired growth, developmental anomalies, altered swimming behaviour, and changes in gene expression. Both UTWR and TWR exposure induced significant toxicity in zebrafish larvae, though the toxicity caused by TWR was notably lower than that of UTWR. This study shows that current filtration methods of tunnel wash water reduce the levels of most pollutants, however, more research is needed on how tunnel wash-water runoff affect aquatic ecosystems.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102096"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the sidelined pollutant: Reviving the fight against heavy metal contamination in an era of emerging contaminants","authors":"Odera R. Umeh ,&nbsp;Eziafakaego M. Ibo ,&nbsp;Chima I. Eke ,&nbsp;Hilda C. Afeku-Amenyo ,&nbsp;Duke U. Ophori","doi":"10.1016/j.toxrep.2025.102073","DOIUrl":"10.1016/j.toxrep.2025.102073","url":null,"abstract":"<div><div>Groundwater contamination by heavy metals (HMs) remains a pressing global concern, presenting substantial risks to humans, animals, plants, and the environment. Although emerging pollutants have received increasing attention, the adverse impacts of HM have not been adequately resolved. This comprehensive review examines the current state of knowledge regarding HM in groundwater, addressing sources, global trends, transport, fate, sampling techniques, modeling, quality control, toxicity, treatment, sustainable measures, and vital research gaps. HM research has continued to dwindle since 2022, these chemicals infiltrate groundwater systems through various pathways, and their mobility and bioavailability are affected by changes in climate, geological heterogeneity, and chemical properties. Moreover, HM may interact with other emerging contaminants to enhance migration and toxicity; however, little or no research has been conducted to fully understand cocktail migration mechanisms and impacts in groundwater systems. Despite the existence of various treatment techniques, no single approach has been universally accepted as the sole solution for completely removing HM from drinking water systems. There is a pressing need for standardized and advanced sampling methods, stringent quality control measures, and the incorporation of cutting-edge technologies such as smart water sensors that can detect both charged and uncharged contaminants, and nanotechnology for effective management. The increasing toxicity of HM and their harmful effects on human health and ecosystems emphasize the need for continuous and novel research involving sustainable remedial strategies, as the battle against metal contamination in groundwater systems requires constant dedication, innovative research, and a shared commitment to protecting our environment.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102073"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting mitochondrial damage and ER stress to inhibit ferroptosis in cadmium-induced nephrotoxicity","authors":"Saba Yousaf ,&nbsp;Muhammad Arshad ,&nbsp;Muhammad Raza ,&nbsp;Anmol Fatima ,&nbsp;Khayala Mammadova","doi":"10.1016/j.toxrep.2025.102082","DOIUrl":"10.1016/j.toxrep.2025.102082","url":null,"abstract":"<div><div>This review highlights the pivotal roles of autophagy, ferroptosis, and endoplasmic reticulum (ER) stress in mediating cadmium (Cd)-induced nephrotoxicity. Cadmium exposure results in ER stress, which in turn activates major UPR pathways such as IRE1, ATF6, and PERK. By encouraging lipid peroxidation and suppressing cellular antioxidant defence, these mechanisms worsen ferroptosis and produce a feedback mechanism that increases cellular damage. There are two roles of autophagy in Cd-induced ferroptosis, which include its action in reducing cadmium-induced cytotoxicity by breaking down damaged components, and excessive autophagy, namely ferritinophagy, which promotes ferroptosis by iron dysregulation. The rise of mitochondrial ROS (MitoROS) caused by Cd-induced mitochondrial malfunction aids ferroptosis. This, in turn, causes ER stress and autophagy. This implies that focusing on mitochondrial health could be a useful treatment strategy. Effective treatment approaches include autophagy inhibitors like chloroquine, which have been shown to effectively reduce Cd-induced ferroptosis, and promising medicines that suppress ER stress, such as TUDCA. Desferrioxamine and other iron chelators effectively lower lipid peroxidation and iron dysregulation, therefore preventing ferroptotic cell death. Additionally, a multi-targeted treatment plan is suggested that targets iron metabolism, ER stress, and autophagy. In order to create tailored treatments for Cd-induced nephrotoxicity, this review emphasizes the need for additional study into the molecular pathways of Cd-induced ferroptosis, namely the ER stress-autophagy axis. The goal of future research should be to apply these mechanistic insights to clinical settings to enhance public health outcomes and create efficient therapies for renal failure brought on by cadmium toxicity.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102082"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aflatoxins and fumonisins in nixtamalized corn dough from El Salvador: A two-year survey","authors":"Roberto Hernandez-Rauda ,&nbsp;Oscar Peña-Rodas ,&nbsp;Gissell Arbaiza-Rodríguez ,&nbsp;Marvin Cuadra-Escobar ,&nbsp;Martha Guzman-Rodríguez","doi":"10.1016/j.toxrep.2025.102087","DOIUrl":"10.1016/j.toxrep.2025.102087","url":null,"abstract":"<div><div>Corn is a staple of the Salvadoran diet but is vulnerable to contamination by aflatoxins and fumonisins. While these mycotoxins have been studied in nearby countries, El Salvador lacks similar data, despite over 90 % of its population consuming corn derivatives. This study aimed to monitor aflatoxin and fumonisin levels in nixtamalized corn dough used for making tortillas and assess daily intake for potential exposure. Aflatoxin-positive cases were low at 20 %, with less than 2 % of samples exceeding 10 µg/kg, and none exceeded this limit on average. Fumonisin-positive cases were also low (&lt; 7 %) and only detected in the dry season, with all cases exceeding the maximum limit of 1 mg/kg. The estimated daily intake of aflatoxin exceeded the recommended guidance value of 0 ng/kg body weight per day, varying by locality and season. Moreover, all fumonisin daily intake measurements surpassed the maximum limit of 1 µg/kg body weight per day, showing no seasonal variation. Thus, consuming nixtamalized corn dough contaminated with these mycotoxins poses a potential health risk to Salvadorans.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102087"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contamination level and dietary risk assessment of trace elements in Brassica pekinensis Lour. from gardening areas under tropical conditions","authors":"Anaïs M. Kipelo ,&nbsp;Masi Jothilakshmi ,&nbsp;Dhafer M.M. Al Salah ,&nbsp;Georgette N. Ngweme ,&nbsp;Emmanuel K. Atibu ,&nbsp;Crispin Mulaji ,&nbsp;Periyasamy Sivalingam ,&nbsp;John W. Poté","doi":"10.1016/j.toxrep.2025.102165","DOIUrl":"10.1016/j.toxrep.2025.102165","url":null,"abstract":"<div><div>This study examined the levels of trace elements in <em>Brassica pekinensis Lour</em>. collected from urban gardening sites (Cecomaf and Lutendele) in Kinshasa (Democratic Republic of the Congo) and associated potential human health risks for the consumer. The toxic metal concentrations in leaf samples were analysed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and Atomic Absorption Spectrophotometer (AAS). Results showed that Cr, Cu, Cd, Pb, and Hg concentrations in samples from both sites exceeded the FAO/WHO maximum permissible limits, with Cecomaf displaying notably high levels of Cu (115.39 mg·kg⁻¹), Cd (2.95 mg·kg⁻¹), Pb (30.94 mg·kg⁻¹), and Hg (0.058 mg·kg⁻¹). Health risk assessments associated with the consumption of <em>Brassica pekinensis</em> L, based on Estimated Daily Intake (EDI), Target Hazard Quotient (THQ), and Hazard Index (HI), indices indicated that EDI values for Cd and Pb exceeded recommended limits in several samples, while THQ values exceeded 1 for most metals except As, suggesting potential non-carcinogenic risks. HI values ranged from 2.98 to 16.11 at Cecomaf and 4.85–12.15 at Lutendele, highlighting a high cumulative risk from individual and multi-metal exposure to consumers. Monte Carlo simulation further confirmed these findings by showing that a significant proportion of the exposed population exceeded the WHO safety thresholds for Cd, Pb, and Cu, thereby reinforcing the robustness of the deterministic risk estimates and illustrating the uncertainty associated with age, sex, and local consumption variability. Spearman correlation analysis revealed strong positive associations between Cr–As, Cr–Pb, and Cd–Hg, suggesting common anthropogenic sources or shared environmental pathways. Results of this study highlight the importance of continuous monitoring of trace elements in leafy vegetables for food safety evaluation, adopting stricter agricultural practices in policy making and management, and public health measures to mitigate long-term exposure risks to urban and peri-urban areas populations.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102165"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild and reversible nephrotoxicity following repeated administration of damnacanthal in nude mice","authors":"Noppanan Kotsaouppara ,&nbsp;Thunyatorn Yimsoo ,&nbsp;Worapapar Treesuppharat ,&nbsp;Jeeraphong Thanongsaksrikul ,&nbsp;Potjanee Srimanote","doi":"10.1016/j.toxrep.2025.102088","DOIUrl":"10.1016/j.toxrep.2025.102088","url":null,"abstract":"<div><div>Damnacanthal was previously shown to be a promising colorectal cancer therapeutic candidate. Its efficacy relied on multiple administrations. This study, therefore, aims to assess the renal toxicity of 20 mg/kg damnacanthal (DAM20) in nude mice following three, seven and 14 repeated administrations. No clinical signs of renal toxicity and abnormal renal tissue histopathology were demonstrated. Seven repeated doses of DAM20 resulted in a decrease in BUN, increased urine-serum creatinine ratio, and urine microalbumin leakage (<em>p</em>-value = 0.031, 0.016 and 0.028, respectively), indicating the perturbation of kidney and liver functions. Some of these abnormalities were reversible to the normal ranges when the treatment continued to 14 repeated doses. However, significant kidney enlargement and increased urine creatinine (<em>p</em>- value = 0.032 and 0.030) were observed, indicating fluid retention and chronic kidney disease. Immunohistochemical analysis and TUNEL assay consistently demonstrated the absence of cleaved caspase-3 expression, DNA fragmentation, and infiltration of pan-macrophages (F4/80) and M2 macrophages (CD206) in the renal tissues of all mice subjected to three, seven, and 14 repeated doses of DAM20. A single exception was observed in one mouse from the 14-dose group, which exhibited minimal cleaved caspase-3 activation (0.14 % positive area). However, a significant increase in KIM-1 expression in renal tissue following 14 repeated doses of DAM20 (<em>p</em>- value = 0.012) indicated the presence of renal tubular injury. Interestingly, the absence of DNA fragmentation and macrophage infiltration in the renal cortex suggests that the DAM20-induced injury was mild, successfully resolved through endogenous repair mechanisms, and did not progress to irreversible damage or tissue remodeling. In conclusion, this study demonstrated that repeated administration of DAM20 in nude mice resulted in mild and reversible nephrotoxicity. However, further large-scale investigations are warranted to gain a more comprehensive understanding of damnacanthal toxicity profile and to ensure its safe use in potential therapeutic applications.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102088"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute recreational drug and ethanol poisoning among adolescents: An observational study from Oslo, Norway 2014–2023","authors":"Ingrid M. Stenbeck ,&nbsp;Lüsette A. Subi ,&nbsp;Mette Brekke ,&nbsp;Odd Martin Vallersnes","doi":"10.1016/j.toxrep.2025.102134","DOIUrl":"10.1016/j.toxrep.2025.102134","url":null,"abstract":"<div><h3>Aims</h3><div>To keep track on trends and changes over time, we describe drugs taken, clinical course, and incidence of recreational drug and ethanol poisoning among adolescents in Oslo, Norway, from 2014 to 2023.</div></div><div><h3>Methods</h3><div>We included all patients ≤ 20 years presenting to the city’s main emergency primary care clinic with recreational drug poisoning in 2014–2023, from 2018 also including sole ethanol poisoning. Data were retrospectively collected from local patient records. Incidences were estimated per 1000 inhabitants in Oslo aged 10–20 years per year.</div></div><div><h3>Results</h3><div>There were 1209 recreational drug poisonings, 51.1 % among girls. Cannabis was taken in 37.1 % of the cases, benzodiazepines in 22.2 %, heroin in 17.1 %, cocaine in 14.6 %, amphetamine in 13.1 %, and methylenedioxymethamphetamine (MDMA) in 12.2 %. More than one drug was taken in 406 (33.6 %) cases. There were 1675 sole ethanol poisonings, 59.9 % among girls. During the pandemic years 2020 and 2021 there was a temporary decrease in the incidence of sole ethanol poisoning, accompanied by an increase in recreational drug poisoning. Otherwise, the incidences were stable, except a marked increase for recreational drugs in 2023: recreational drug poisoning 1.20 (95 % CI 0.97–1.50) in 2014 and 3.55 (3.16–3.99) in 2023; sole ethanol poisoning 3.94 (3.50–4.42) in 2018 and 3.96 (3.54–4.42) in 2023. The incidence of recreational drug poisoning among girls were lower than among boys early in the study period, but higher from 2021.</div></div><div><h3>Conclusions</h3><div>Recreational drug poisoning in Oslo among adolescents was dominated by ethanol, cannabis, benzodiazepines, and heroin.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102134"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged intermittent hemodialysis using a standard dialysate flow rate for severe overdose of sustained-release valproic acid: A case report","authors":"Hiroki Inoue ,&nbsp;Satoshi Yoshikawa ,&nbsp;Nobuyasu Matsukawa,&nbsp;Atsushi Shima ,&nbsp;Takuya Nishizawa ,&nbsp;Takeshi Ueda","doi":"10.1016/j.toxrep.2025.102132","DOIUrl":"10.1016/j.toxrep.2025.102132","url":null,"abstract":"<div><h3>Background</h3><div>Valproic acid poisoning can be life threatening and may require urgent extracorporeal elimination. In particular, sustained-release formulations pose a challenge, as conventional short-duration intermittent hemodialysis may fail to remove the drug sufficiently because of delayed and prolonged drug absorption. While prolonged intermittent hemodialysis is a rational alternative, its clinical effectiveness and safety in cases of severe sustained-release sodium valproate overdose have not been reported.</div></div><div><h3>Case</h3><div>A woman in her 20 s developed coma after ingesting 45 g (approximately 1100 mg/kg) of sustained-release VPA. Prolonged IHD was delivered for 22 h using a blood flow rate (Qb) of 180 mL/min and a dialysate flow rate (Qd) of 500 mL/min. Her consciousness improved in parallel with a marked decline in serum VPA levels, and she was discharged without any neurological sequelae. A two-point, on-dialysis apparent elimination half-life was estimated to be approximately 2.35 h.</div></div><div><h3>Conclusion</h3><div>In this case, prolonged IHD appeared to have an effect in decreasing VPA concentrations and was safely implemented with monitoring.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"15 ","pages":"Article 102132"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}