Fatal vitamin C-associated acute renal failure.
Although daily ingestion of high-dose vitamin C is generally regarded as largely innocuous, fatal nephrotoxicity can occur in some rare circumstances. We report a case where the patient, who chose to forgo any advanced conventional medical intervention (dialysis and mechanical ventilation), had failed to disclose his use of high-dose vitamin C and subsequently died. Intra-renal oxalate crystal deposition was demonstrated at autopsy. Directed enquiry with the family then revealed his high-dose vitamin C usage. Even though fully-informed discussion was limited by incomplete prospective disclosure, it remains the prerogative of any competent patient to decline any treatment, including those that may be considered life-saving.
McHugh
G J
GJ
Intensive Care Unit, Palmerston North Hospital, Palmerston North, New Zealand.
Graber
M L
ML
Freebairn
R C
RC
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D001205:Ascorbic Acid / Q000506:poisoning*; D001774:Blood Chemical Analysis; D016638:Critical Illness / Q000628:therapy*; D062787:Drug Overdose; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D016312:Treatment Refusal; D014815:Vitamins / Q000506:poisoning*
D014815:Vitamins; D001205:Ascorbic Acid