Effect of acute paracetamol overdose on changes in serum and urine electrolytes.
OBJECTIVE
To investigate the effects of acute paracetamol overdose on renal function, serum and urine electrolyte excretion in man.


METHODS
Two studies were performed in patients admitted with paracetamol overdose: a retrospective study examining changes in serum electrolytes, and a prospective study evaluating changes in serum and urine electrolytes. A control group with SSRI overdose was included in the prospective study.


RESULTS
There was a significant dose-dependent relationship between admission (4 h) paracetamol concentration and fall in serum potassium in the retrospective study (P < 0.01) and a significant positive relationship between serum paracetamol at 4 h and fractional excretion of potassium at 12 h postingestion (P < 0.01) in the prospective study. No changes were seen in the control group. No cases developed renal failure.


CONCLUSIONS
Paracetamol overdose is associated with dose-related hypokalaemia, and kaliuresis of short duration (<24 h), suggesting a specific renal effect of paracetamol in overdose perhaps via cyclo-oxygenase inhibition. This effect seems distinct from any nephrotoxic effect of paracetamol.
Pakravan
N
N
NPIS Edinburgh, Edinburgh, UK. dr_p_n@yahoo.com
Bateman
D N
DN
Goddard
J
J
D000082:Acetaminophen / Q000097:blood / Q000506:poisoning* / Q000652:urine; D000293:Adolescent; D000328:Adult; D062787:Drug Overdose; D004573:Electrolytes / Q000097:blood* / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
D004573:Electrolytes; D000082:Acetaminophen