We describe a 66-year-old woman undergoing hemodialysis treatment who developed life-threatening metabolic acidosis (pH of 6.67) with a high anion gap (41 mEq/L [41 mmol/L]) and marked hyperkalemia (9.1 mEq/L [9.1 mmol/L]) after consuming sulfur. Because of an increasing number of patients with chronic renal failure and dialysis-dependent end-stage renal disease, as well as persistence of folk remedies using sulfur, recognition of the potential dangers of self-administered sulfur seems appropriate.

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