An extreme and life-threatening case of recurrent D-lactate encephalopathy.
Level 4 - case-series / case-control
Single clinical case report
PubMed 21310737 · doi:10.1093/ndt/gfq829
What was done
A single case report describing a patient with end-stage renal disease who developed recurrent, severe D-lactic acid encephalopathy leading to respiratory failure, alongside a review of potential treatment paradigms targeting substrate, catalyst, and pathologic product.
What was found
The abstract reports no numerical values or laboratory metrics. Qualitatively, the patient experienced severe D-lactic encephalopathy requiring endotracheal intubation and mechanical ventilation, which promptly reversed to baseline sensorium following treatment that included hemodialysis.
Why it matters
This report indicates that impaired renal clearance in end-stage renal disease can elevate typically mild D-lactic acidosis to life-threatening encephalopathy, identifying hemodialysis as an effective clearance method.
Limits
This is an uncontrolled single-patient case report (n = 1), precluding generalization. No specific quantitative data (such as D-lactate levels, pH, or clearance rates) are provided in the abstract, and the simultaneous use of multiple therapies limits the ability to isolate the effect of hemodialysis alone.
Cited by
- supports D-lactate is neurotoxic.