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[Acute kidney failure caused by poisoning].
Srpski Arhiv Za Celokupno Lekarstvo
|March 1, 1991
Summary
Acute renal failure (ARF) from poisoning, often caused by acetic acid, requires specialized care. Peritoneal dialysis is recommended over hemodialysis due to lower bleeding risk and better monitoring for poisoned patients.
Area of Science:
- Nephrology
- Toxicology
- Critical Care Medicine
Context:
- Acute renal failure (ARF) is a critical condition often resulting from poisoning.
- Acetic acid poisoning is a significant cause of ARF, leading to oligoanuric presentations.
- Management of ARF in poisoning cases presents unique challenges and requires multidisciplinary input.
Purpose:
- To present clinical experience in managing acute renal failure secondary to poisoning.
- To evaluate the efficacy and complications of peritoneal dialysis in poisoned patients with ARF.
- To highlight the importance of specialized treatment protocols and team collaboration for improved outcomes.
Summary:
- Thirty patients presented with oligoanuric ARF due to poisoning, with acetic acid being the most common etiological agent.
- Peritoneal dialysis was utilized in 34 patients experiencing elevated serum urea and creatinine levels.
- Common complications included oesophagitis, bleeding, mediastinitis, pneumonia, and acute abdomen, contributing to mortality.
Impact:
- A mortality rate of 24.4% was observed, exceeding the center's average for ARF, primarily due to the corrosive effects of ingested acids.
- Successful treatment resulted in recovery for 31 patients, with a mean creatinine clearance of 65.0 ± 27.7 ml/min.
- Peritoneal dialysis is suggested as a preferable modality over hemodialysis for ARF due to poisoning, considering bleeding risks and intra-abdominal monitoring advantages.