Which laboratory data would warrant immediate intervention when administering edetate calcium disodium (calcium EDTA) for lead poisoning?

• A. ALT/GPT 30 IU/mL
• B. Calcium 9.5 mg/dL
• C. BUN 15 mg/dL
• D. Creatinine 2.4 mg/dL

Answer: (D)

Renal function monitoring is essential with calcium disodium EDTA because the drug is cleared by the kidneys and can cause or worsen nephrotoxicity. An elevated creatinine level indicates impaired kidney function, which raises the risk of further kidney injury from the chelation therapy and may reduce the drug’s ability to be excreted properly. In this case, the creatinine level of 2.4 mg/dL signals a need to intervene immediately—hold or modify the infusion and contact the clinician to reassess treatment. The other values (ALT within normal range, calcium normal, BUN normal) do not indicate an immediate need for action.