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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr0320102826.
Published online Aug 31, 2010. doi:  10.1136/bcr.03.2010.2826
PMCID: PMC3028043
Unusual association of diseases/symptoms
Polyurethane foam pica in a patient with excessive interdialytic weight gain
Osasuyi Iyasere,1 Ying Allington,2 and Michele Cafferkey2
1Basildon and Thurrock University Hospital NHS Trust, Basildon, UK
2Department of Renal Medicine, Basildon and Thurrock University Hospital NHS Trust, Basildon, UK
Correspondence to Osasuyi Iyasere, uyit2001/at/yahoo.com
Abstract
Maintaining fluid balance in haemodialysis patients is important because of the adverse effects of excessive interdialytic weight gain. This often requires fluid restriction that patients often struggle with. We report a case of a 31-year-old female diabetic patient on haemodialysis with repeated excessive interdialytic weight gains despite fluid restriction and dry weight adjustment. It was subsequently discovered that she devised an unusual, albeit unsuccessful, strategy of eating the polyurethane foam from her dialysis chair while increasing her fluid intake hoping that it would absorb excess water in the gut! This under-diagnosed phenomenon known as pica has been reported in renal patients with substances such as ice, clay and baking soda.
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