Haemodialysis to increase elimination has been greatly overused in poisoning and recommended by some authors on the basis that some drug was removed by this process or that the patient survived (ridiculous for all but universally fatal conditions and particularly so for poisoning, which has an in-hospital mortality of less than 1% and an ICU mortality of less than 5%). Renal failure developing as a consequence of poisoning is usually treated as acute renal failure in a conventional manner and will not be discussed.
In addition, the toxic effects of the poisons should be serious, related to the plasma concentration, and not treatable easily by less invasive means.
Serious adverse effects directly due to haemodialysis are unusual if performed by staff familiar with the procedure. The most frequent significant adverse effect is hypotension and extra care should be taken with monitoring volume depletion as the fluid requirements of these patients are liable to change far more rapidly than those of the usual patient with renal failure. Simultaneous monitoring of central venous pressure is advisable in some circumstances.