The clinical features of acute kidney injury in patients with acute paraquat intoxication.
BACKGROUND
Paraquat (PQ) is a non-selective herbicide that generates reactive oxygen species in vivo. We hypothesized that acute kidney injury (AKI) in patients with acute PQ poisoning would provide a model for the clinical features of ROS-induced AKI.


METHODS
From January 2007 to December 2007, 278 patients with acute PQ intoxication were included in the study. AKI was defined based on the RIFLE classification. The serial changes of creatinine (Cr), the incidence of AKI and the mortality according to the RIFLE classification were analysed.


RESULTS
An initial serum Cr >1.2 mg/dL was a significant predictor of mortality [odds ratio 9.00, 95% C.I. (4.747, 17.061), P < 0.01]. The incidence of AKI was 51.4% among the 173 patients who had an initial serum Cr < or =1.2 mg/dL. Among them, 34.7% were the failure group and oliguric AKI was observed in 10 patients. The average peak serum Cr level, among the 13 survivors in the failure group, was 4.38 mg/dL at the fifth day, after ingestion, and their Cr level normalized within 3 weeks. None of the 13 survivors had permanent loss of renal function. The estimated amount of PQ ingestion was a predictor of the incidence of AKI. The mortality risk was significantly higher in the failure group than in the group without failure.


CONCLUSIONS
The clinical feature was characterized by fully developed AKI at the fifth day after PQ ingestion and normalized within 3 weeks without exception.
Kim
Su-Ji
SJ
Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Gil
Hyo-Wook
HW
Yang
Jong-Oh
JO
Lee
Eun-Young
EY
Hong
Sae-Yong
SY
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000401:mortality / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010269:Paraquat / Q000506:poisoning*; D017382:Reactive Oxygen Species / Q000378:metabolism; D055815:Young Adult
D006540:Herbicides; D017382:Reactive Oxygen Species; D010269:Paraquat