title: [Primary polyuric kidney failure and acute yellow liver dystrophy following infusion of glucose substitutes in children].
abstract: Four children (aged 2 1/2-14 years) were given infusions of fructose, sorbitol and xylitol after sustaining head trauma (n = 3) or after attempted suicide with carbromal (n = 1). After transitory polyuria renal failure of varying severity set in three to five days after onset of the infusion treatment. Serum osmolality fell to 265-274 mosm/kg, haematocrit to 0.25-0.31, and hyponatraemia developed. Serum creatinine rose to maximally 256-930 mumol/l. Liver damage developed in parallel to the renal failure, two children dying with acute yellow liver atrophy. Two children--given symptomatic treatment with balanced equalization of the hyponatraemia, administration of frusemide and adjusted carbohydrate substitution--were discharged after four to eight weeks with normal renal and hepatic functions. Dialysis was not required. The hepatic and renal abnormalities must have been due to the high amounts of fructose, sorbitol and xylitol, to a total of 7.1-23.0 g/kg on the first day, well above recommended levels.
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000293:Adolescent; D056486:Chemical and Drug Induced Liver Injury; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000628:therapy*; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D005260:Female; D005632:Fructose / Q000009:adverse effects; D006801:Humans; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D011141:Polyuria / Q000139:chemically induced; D013012:Sorbitol / Q000009:adverse effects; D013406:Suicide, Attempted / Q000628:therapy*; D014993:Xylitol / Q000009:adverse effects
chemical_list: D004040:Dietary Carbohydrates; D005632:Fructose; D013012:Sorbitol; D014993:Xylitol
vernacular_title: Primär polyurisches Nierenversagen und akute gelbe Leberdystrophie nach Infusion von Zuckeraustauschstoffen im Kindesalter.