The pattern of acute toxic nephropathy in Ife, Nigeria

All cases of acute renal failure (ARF) seen over a two year (1993-94) period were evaluated. Those that had acute toxic nephropathy were further studied to determine the aetiologic agents involved, the clinical features and the effect of available treatment on its prognosis. Ten cases (33.3%) out of 30 ARF had toxins responsible for their renal failure. They were 8 males and 2 females. Agents responsible were green water in 2, naphthalene containing remedies in 2 and analgesic combination in 1 while herbal remedies were implicated in 5 cases. Anuria was a prominent feature occurring in 9 (90%) of the patients. The patients were uraemic with a mean serum creatinine of 1460 +/- 485.0 umol/1 and urea of 33.1 +/- 5.3 mmol/1 on admission. They were all anaemic with packed cell volume less than 18% in eight of the patients. Six (60%) of the patients required haemodialysis while 4 were managed conservatively. Prognosis was good as 8 (80%) of the patients survived and were followed up in the clinic for periods anging 6 to 18 months and their serum creatinine and urea levels normalised. It is concluded that acute toxic nephropathy is common in our practice, and it is eminently preventable. The prognosis is good if dialytic therapy is available.