title: Clinical presentation, treatment and outcome of paraphenylene-diamine induced acute kidney injury following hair dye poisoning: a cohort study.
abstract: BACKGROUND
  In Africa and Asia hair dye is applied together with henna to decorate the hands and feet. Paraphenylene-diamine (PPD), a highly toxic constituent of hair dye can lead to acute kidney injury (AKI).
  
  
  METHODS
  A cohort study was conducted during the period from April 2012 to March 2013 in Khartoum Teaching Hospital, Sudan. It targeted adults presenting acutely with an evident history and clinical features of hair dye poisoning, together with AKI as per the RIFLE criteria. Analysis of data was done using SPSS.
  
  
  RESULTS
  30 adults were included, their mean age was 25.6 ± 4.2 years, 93.3% were females. Exposure to PPD was suicidal in 86.7%. The mean duration to onset of renal symptoms was 34.8 ± 7.6 hours, maximum median serum creatinine was 8.6 ± 2.3 mg/dl, 86.7% had loss of kidney function as per the RIFLE classification and required dialysis. Initial renal recovery was seen after a mean duration of 9.8 ± 2.2 days. One patient died, 3.3%; all others, 96.7%, recovered normal kidney function. The amount of ingested PPD correlated significantly to the severity of symptoms, number of dialysis sessions required and time for renal recovery with P values < 0.05.
  
  
  CONCLUSIONS
  Hair dye poisoning was associated with prolonged hospital stay, requirement of dialysis and increased morbidity. The severity of symptoms directly correlates to the dose of PPD ingested, with the kidney damage being reversible in almost all survivors.
authors: Faculty of Medicine, University of Khartoum, Sudan.
authors: Mazin
authors: M
authors: Shigidi
authors: Renal Unit, Khartoum Teaching Hospital, Sudan.
authors: Osama
authors: O
authors: Mohammed
authors: Renal Unit, Khartoum Teaching Hospital, Sudan.
authors: Mohammed
authors: M
authors: Ibrahim
authors: Cardiology Department, Al Ain Hospital, United Arab Emirates.
authors: Elshafie
authors: E
authors: Taha
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006202:Hair Dyes / Q000506:poisoning*; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D010655:Phenylenediamines / Q000506:poisoning*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods; D013397:Sudan / Q000453:epidemiology; D013406:Suicide, Attempted; D013997:Time Factors; D055815:Young Adult
chemical_list: D006202:Hair Dyes; D010655:Phenylenediamines; C029728:4-phenylenediamine
keywords: Hair dye poisoning; acute kidney injury; paraphenylene-diamine