title: Antioxidant treatment and outcome of Cortinarius orellanus poisoning: a case series.
abstract: OBJECTIVE
  To study the frequency, severity, and long-term outcome of renal injury in Cortinarius orellanus poisoning, to evaluate the association between the ingested amount of C. orellanus and outcome, and to evaluate the effect of N-acetylcysteine and corticosteroid treatment on outcome.
  
  
  METHODS
  Case series of eight patients. Diagnosis and severity of acute kidney injury (AKI) and chronic kidney disease (CKD) were classified according to current AKI and CKD definitions. N-acetylcysteine and corticosteroids were administered to six patients, former according to the standard for paracetamol poisoning.
  
  
  RESULTS
  All patients developed AKI, six in the most severe stage and four required renal replacement therapy (RRT). After 12 months, seven patients presented with CKD, of whom three required chronic RRT and further two were in advanced CKD. AKI and CKD severity highly correlated with the consumed amounts of Cortinarius orellanus (r = 0.98, p < 0.001 and r = 0.78, p = 0.02, respectively) but not with N-acetylcysteine and corticosteroid treatment.
  
  
  CONCLUSIONS
  AKI and CKD by current definitions and classifications are frequent and severe after Cortinarius orellanus poisoning. The ingested amount of Cortinarius orellanus correlates with the severity of both AKI and CKD. N-acetylcysteine and corticosteroid treatment do not seem to have a beneficial effect on either AKI or CKD.
authors: Division of Nephrology, HELIOS Klinikum, University of Witten/Herdecke , Wuppertal , Germany .
authors: Scott-Oliver
authors: SO
authors: Grebe
authors: Martin
authors: M
authors: Langenbeck
authors: Andreas
authors: A
authors: Schaper
authors: Siegmar
authors: S
authors: Berndt
authors: Duaa
authors: D
authors: Aresmouk
authors: Stefan
authors: S
authors: Herget-Rosenthal
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D055363:Cortinarius; D004359:Drug Therapy, Combination; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000150:complications* / Q000188:drug therapy; D051436:Renal Insufficiency, Chronic / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D016166:Free Radical Scavengers; D000111:Acetylcysteine