Table 1.

Relevant case report characteristics recommended by the EXTRIP workgroup [10]

	Case 1	Case 2
General information
Age (years)	54	53
Weight (kg)	54	75
Height (cm)	168	157
Gender	♀	♀
Concurrent diseases	Breast cancer, chronic pain syndrome, depression	MGUS, depression, chronic pain syndrome
Source providing the history of the poisoning	Paramedics	Paramedics
Time from ingestion to hospital admission (h)	7.5	8.5
Known co-medication	Lorazepam	Pantoprazole, citalopram, mirtazapine
Other toxins	Tilidine, ethanol	Ibuprofen, β-blockers, alcohol
Activated charcoal given	No	Yes
ICU stay (days)	3	5
Discharge from hospital (days)	3	20
Laboratory values
Albumin (g/L)	34.8	42
Creatinine at baseline (µmol/L)/eGFR CKD-EPI	36/115.3	643/6 (AKIN III)
Serum amitriptyline peak concentration (µg/L)	458	412
Serum nortipytilin peak concentrations (µg/L)	283	259
Serum tilidine/nortilidin peak concentrations (µg/L)	56/849	NA
Urine excretion (mL/days)	3100	anuria
Urine amitriptyline concentration (µg/L)	623	NA
Haematocrit (%)	40	36.5
ECTR characteristics
Modality of ECTR	Intermitted haemodialysis	Intermitted haemodialysis
Indication for ECTR	Detoxification	AKI, rhabdomyolysis, detoxification
ECTR start after admission (h)	2.5	1.5
Dialyser (material/surface)a	HCO dialyser (polysulfone, 1.8 m2)	High-flux dialyser (polysulfone, 1.3 m2) HCO dialyser (polysulfone, 1.8 m2)
Dialysis time (min)	295 (first treatment) 220 (second treatment)	320 (first treatment) 775 (second treatment)/350 (HCO)
Blood flow (mL/min)	300 (first treatment) 110 (second treatment)	240 (high-flux) 240 (high-flux)
Dialysate flow (mL/min)	300 (first treatment) 55 (second treatment)	240 (high-flux) 240 (high-flux)
Ultrafiltration rate (mL/h)	50	50 (first treatment)/50 (second treatment)/200 (HCO)
Anticoagulation	Heparin	Heparin
Amitriptyline reduction ratio (%)b	27	28 (HCO)
ECTR amitriptyline clearance (mL/min)c	58	7 (high-flux) 33 (HCO)
Total amount of amitriptyline in the collected dialysate (µg)	211	920 (high-flux) NA (HCO)

AKI, acute kidney injury; AKIN, acute kidney injury network; CKD-EPI, chronic kidney disease epidemiology collaboration; eGFR, estimated glomerular filtration rate; HPLC, high-performance liquid chromatography; MS/MS, tandem mass spectrometry.

Amitriptyline and nortriptyline were quantified (detection limit 5 µg/L) by HPLC followed by electrospray ionization and mass spectrometric detection and quantification of selected ion fragments (triple quadrupole MS/MS, API2000, PE Sciex) after simple deproteinization with acetonitrile/methanol. Tilidine and its metabolites were similarly quantified (detection limit 5 µg/L) by HPLC-MS (Waters Micromass, Quattro Micro) after fluid extraction with cyclohexane.

^aAdditional membrane characteristics are reported elsewhere [11].

^bCalculations of reduction ratios were executed according to equation (1):

$$\text{RR}=(C_{\mathrm{post}}-C_{\mathrm{pre}})/C_{\mathrm{pre}}\times 100$$ (1)

^cDialyser clearance was measured according to equation (2), using the patients’ hematocrit concentration (Hct) at the time of clearance sampling:

$$K_{\mathrm{plasma}}=\text{QB}\times (1-\text{Hct}/100)\times ((C_{\mathrm{art}}-C_{\mathrm{ven}})/C_{\mathrm{art}})$$ (2)