Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. May 6, 2017; 6(3): 162-167
Published online May 6, 2017. doi: 10.5527/wjn.v6.i3.162
Acute kidney injury from different poisonous substances
Rubina Naqvi
Rubina Naqvi, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi 74200, Pakistan
Author contributions: Naqvi R contributed to this manuscript solely.
Institutional review board statement: This was verbal statement given by IRB, that if data is collected from records and not requires any extra visit of patient or any laboratory test, written permission is not desired.
Informed consent statement: Informed consent as routine taken from all patients reaching to emergency of this hospital.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rubina Naqvi, MBBS, MD (Nephrology), Fellow ISN, PGD Bioethics, Professor of Nephrology, Sindh Institute of Urology and Transplantation, Civil Hospital, Sardar Yaqoob Ali Khan Road, Karachi 74200, Pakistan. naqvirubina@yahoo.com
Telephone: +92-301-2489172
Received: August 25, 2016
Peer-review started: August 27, 2016
First decision: November 20, 2016
Revised: March 8, 2017
Accepted: March 21, 2017
Article in press: March 22, 2017
Published online: May 6, 2017
Processing time: 252 Days and 3.5 Hours
Abstract
AIM

To report our experience of acute kidney injury (AKI) developed after exposure to poisonous substance.

METHODS

Retrospective study where data was collected from case records of patients coming to this institute during January 1990 to May 2016. This institution is a tertiary care center for renal care in the metropolitan city of Karachi, Pakistan. History of ingested substance, symptoms on presentation, basic laboratory tests on arrival, mode of treatment and outcome were recorded from all patients and are presented here. Patients developing AKI after snake envenomation or scorpion stings are not included in this study.

RESULTS

During studied period 184 cases of AKI developing after poisoning were seen at our institution. The largest group was from paraphenyline diamine poisoning comprising 135 patients, followed by methanol in 8, organophosphorus compounds in 5, paraquat in 5, copper sulphate in 5, tartaric acid in 4, phenobarbitone in 3 and benzodiazipines, datura, rat killer, fish gall bladder, arsenic, boiler water, ammonium dichromate, acetic acid and herbs with lesser frequency. In 8 patients multiple substances were ingested in combination. Renal replacement therapy was required in 96% of patients. Complete recovery was seen in 72.28% patients, 20% died during acute phase of illness.

CONCLUSION

It is important to report poisonous substances causing vital organ failure to increase awareness among general population as well as health care providers.

Keywords: Paraphenylene diamine; Organophosphorus compounds; Paraquat; Methanol; Poisons; Acute kidney injury

Core tip: During our daily life we are exposed to certain substances/compounds, which may be used as pesticides, herbicides, insecticides, coloring inks, photocopying or may found in some plants. Use of these compounds intentionally or accidentally as per oral ingestion and absorption via gastro intestinal tract or taken via parenteral route may cause hazardous, sometimes lethal effects. Current study highlights acute kidney injury as result of some of these poisons, dealt at a tertiary renal care unit. Awareness regarding pathophysiological consequences, need of early referral to particular specialized center and at society level at par is important issue addressed here.