Intermittent hemodialysis is superior to continuous veno-venous hemodialysis/hemodiafiltration to eliminate methanol and formate during treatment for methanol poisoning

Kidney Int. 2014 Jul;86(1):199-207. doi: 10.1038/ki.2014.60. Epub 2014 Mar 12.


During an outbreak of methanol poisonings in the Czech Republic in 2012, we were able to study methanol and formate elimination half-lives during intermittent hemodialysis (IHD) and continuous veno-venous hemodialysis/hemodiafiltration (CVVHD/HDF) and the relative impact of dialysate and blood flow rates on elimination. Data were obtained from 11 IHD and 13 CVVHD/HDF patients. Serum methanol and formate concentrations were measured by gas chromatography and an enzymatic method. The groups were relatively comparable, but the CVVHD/HDF group was significantly more acidotic (mean pH 6.9 vs. 7.1 IHD). The mean elimination half-life of methanol was 3.7 and formate 1.6 h with IHD, versus 8.1 and 3.6 h, respectively, with CVVHD/HDF (both significant). The 54% greater reduction in methanol and 56% reduction in formate elimination half-life during IHD resulted from the higher blood and dialysate flow rates. Increased blood and dialysate flow on the CVVHD/HDF also increased elimination significantly. Thus, IHD is superior to CVVHD/HDF for more rapid methanol and formate elimination, and if CVVHD/HDF is the only treatment available then elimination is greater with greater blood and dialysate flow rates.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antidotes / therapeutic use
  • Blood Flow Velocity
  • Czech Republic
  • Female
  • Formates / blood*
  • Half-Life
  • Hemodiafiltration / methods
  • Hemodialysis Solutions
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Methanol / blood*
  • Methanol / poisoning*
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis / methods


  • Antidotes
  • Formates
  • Hemodialysis Solutions
  • formic acid
  • Methanol