Plasma renin activity during the development of paracetamol (acetaminophen) induced acute renal failure in man

Plasma renin activity has been measured daily in 36 patients suffering from self poisoning with acetaminophen. In 3 developing porto-systemic encephalopathy terminal renal failure developed with high plasma renin activity. In 2 who developed acute renal failure without porto-systemic encephalopathy, plasma renin activity was noted to rise before serum creatinine and to return to initial levels after 3 or 4 days while renal failure persisted. Six other patients with similar hepatic damage showed comparable rises in renin without developing renal failure. Our findings are consistent with but do not establish a pathogenetic role for renin in acetaminophen-induced acute renal failure. It is suggested that other factors may act with renin to bring about renal failure.