Renal failure prevalence in poisoned patients.
BACKGROUND
Renal failure is an important adverse effect of drug poisoning. Determining the prevalence and etiology of this serious side effect could help us find appropriate strategies for the prevention of renal failure in most affected patients.


OBJECTIVE
The present study is aimed to identify drugs that induce renal failure and also to find the prevalence of renal failure in patients referred to emergency departments with the chief complaint of drug poisoning, in order to plan better therapeutic strategies to minimize the mortality associated with drug poisoning induced renal failure.


METHODS
This cross-sectional study surveyed 1500 poisoned patients referred to the Emergency Department of Baharloo Hospital in Tehran during 2010. Demographic data including age and gender as well as clinical data including type of medication, duration of hospital stay, and presence of renal failure were recorded. Mann-Whitney U test and chi-squared statistics were used to analyze the results.


RESULTS
A total number of 435 patients were poisoned with several drugs, 118 patients were intoxicated with sedative-hypnotic drugs, 279 patients were exposed to opium, and 478 patients were administered to other drugs. The method of intoxication included oral 84.3%, injective 9%, inhalation 4.3% and finally a combination of methods 2.3%. Laboratory results revealed that 134 cases had renal failure and 242 had rhabdomyolysis. The incidence of rhabdomyolysis and renal failure increased significantly with age, and also with time of admission to the hospital. Renal failure was reported in 25.1% of patients exposed to opium, vs. 18.2% of patients poisoned with aluminum phosphide, 16.7% of those with organophosphate, 8% with multiple drugs, 6.7% with alcohol, heavy metals and acids, and 1.7% with sedative hypnotics.


CONCLUSIONS
Based on the findings of this study, there is a high probability of renal failure for patients poisoned with drugs such as opium, aluminum phosphide, and multiple drugs as well as the patients with delayed admission to the hospital, and it is necessary to seek appropriate treatment to prevent this significant side effect.
Department of Forensic Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
Mohammad
M
Arefi
Department of Forensic Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
Fakhroddin
F
Taghaddosinejad
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran , IR Iran.
Peyman
P
Salamaty
Department of Forensic Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Davood
D
Soroosh
Razavi Hospital, Mashhad, IR Iran.
Hami
H
Ashraf
Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Mohsen
M
Ebrahimi
Drug-Related Side Effects and Adverse Reactions; Renal Insufficiency; Rhabdomyolysis