133 INCIDENCE AND OUTCOME OF ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE PARAQUAT POISONING

N, N’-dimethyl-4, 4’-bipyridinium dichloride (paraquat) is a herbicide commonly used in India that leads to fatal outcome on ingestion. Paraquat interferes in the intracellular electron transfer systems inhibiting the reduction of NADP to NADPH resulting in accumulation of superoxide radical causing lipid cell membranes destruction leading to various organ damage. Life threatening effects such as acute kidney injury as paraquat elimination is mainly by kidney, acute respiratory distress syndrome and multi-organ failure are the causes of mortality in paraquat poisoning. There is no specific antidotes for paraquat poisoning so prevention and aggressive decontamination remains the mainstay of management in case of exposure or ingestion. Paraquat poisoning presentation may vary in cases depending on the amount of paraquat consumed and thus the outcome. Here we report a case of a 17 years old male who presented with acute kidney injury following ingestion of paraquat in a suicidal attempt. In our case, induced vomiting of the stomach content readily after ingestion of the poison, early haemodialysis, use of immunosuppression such as methylprednisolone, cyclophosphamide and antioxidants such as acetylcysteine, Vitamin C and Vitamin E as free radical scavenging agent , supportive measures such as adequate hydration and antibiotics might have helped in the patient’s survival. The case fatality remains very high in paraquat poisoning till date owing to lack of effective treatment options.

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Combine role of haemodialysis, cyclophosphamide and MESNA in management of paraquat poisoning with acute kidney injury

Medpusle International Journal of Medicine ◽

10.26611/10211925 ◽

2021 ◽

Vol 19 (2) ◽

pp. 46-48

Author(s):

Rohan Darekar ◽

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Paraquat Poisoning

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Silent Acute Renal Impairment after Low-dose Paraquat Ingestion

Case Reports in Acute Medicine ◽

10.1159/000501648 ◽

2019 ◽

Vol 2 (2) ◽

pp. 31-34

Author(s):

Hiroshi Ito

Keyword(s):

Acute Kidney Injury ◽

Renal Impairment ◽

Serum Creatinine ◽

Fluid Resuscitation ◽

Low Dose ◽

Kidney Injury ◽

Signs And Symptoms ◽

Specific Intervention ◽

Paraquat Poisoning ◽

Negative Conversion

Paraquat poisoning causes fatal multi-organ failure soon after ingestion. Here we report a case of paraquat poisoning presenting acute kidney injury without any preceding signs and symptoms other than nausea and vomiting. A 77-year-old man was admitted to our hospital because of paraquat ingestion and received fluid resuscitation until the negative conversion of urine paraquat on day 4. Serum creatinine abnormality emerged on the same day, which improved gradually without any specific intervention. Paraquat poisoning can cause silent acute renal impairment. Abundant fluid resuscitation after renal impairment is not essential provided that sufficient fluid is administered beforehand. Repeated screening for renal impairment and sufficient fluid resuscitation are important in the early phase of low-dose paraquat poisoning.

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Acute kidney injury following paraquat poisoning: An uncommon case of acute toxic nephropathy in Nigeria

Journal of Medicine in the Tropics ◽

10.4103/2276-7096.177828 ◽

2016 ◽

Vol 18 (1) ◽

pp. 51

Author(s):

OluseyiA Adejumo ◽

AyodejiA Akinbodewa ◽

OladimejiJ Olafisoye ◽

OluwatosinN Afolabi

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Paraquat Poisoning ◽

Toxic Nephropathy ◽

Uncommon Case ◽

Acute Toxic

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Analysis of Prognostic Factors in Patients with Paraquat Poisoning for Better Therapy Regimen

10.21203/rs.3.rs-37897/v1 ◽

2020 ◽

Author(s):

Ying Xu ◽

Yang Chen ◽

Jingyun Le ◽

Zhimin Chen ◽

Hongju Wang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Prognostic Factors ◽

Survival Rate ◽

Kidney Injury ◽

Survival Group ◽

Therapy Regimen ◽

Paraquat Poisoning ◽

Daily Dose ◽

Abnormal Renal Function

Abstract Background Paraquat poisoning is associated with very high mortality rate and extremely difficult to manage due to lack of antidotes. The purpose of this study was to identify prognostic factors after paraquat poisoning and discuss the efficacy of current therapy regimen. Methods In this retrospective study, 211 paraquat poisoning cases admitted to the First Affiliated Hospital, School of Medicine, Zhejiang University between 1 June 2010 and 30 April 2016 were enrolled. The demographic characteristic, medical records of clinical features, laboratory parameters, therapy regimen and the prognosis were analyzed. Results The overall survival rate was 55.45%. the mean age was 35.85 years old. Twelve patients who ingested paraquat combined with alcohol had a higher survival rate. The patients in survival group ingested less amount of paraquat, presented with lower serum creatinine level at admission, developed lower incidence of acute kidney injury and pulmonary CT deterioration. The survivors were treated with higher dosage of methylprednisolone, daily dose of aspirin, daily dose of rapamycin and lower dose of vitamin C. The frequency of hemoperfusion was much more in the survival group. The Cox regression survival analysis demonstrated larger amount of paraquat ingestion, abnormal renal function at admission or developing acute kidney injury (AKI) after admission were independent risk factors for mortality. Higher dose of methylprednisolone and aspirin were independent protective prognostic factors. Conclusions Non-survivor characteristics are larger amount of paraquat ingestion, manifestation of abnormal renal function at admission or developing AKI after admission, whereas the survivor characteristics are higher dose of methylprednisolone and aspirin.

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A study on clinical profile of paraquat poisoning in a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20173237 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1088

Author(s):

Jagadeesan M. ◽

Nithyananthan P. ◽

Banupriya M. ◽

Mahendrakumar K. ◽

Prasanna Karthik S. ◽

...

Keyword(s):

Acute Kidney Injury ◽

Metabolic Acidosis ◽

Tertiary Care ◽

Kidney Injury ◽

Mortality Rates ◽

Care Hospital ◽

Paraquat Poisoning ◽

Hospital Patients ◽

Life Threatening ◽

Overall Mortality

Background: Paraquat poisoning is a weedicide used rarely for suicide. It is now being increasingly as this type of suicidal poisoning is almost always fatal as there is no specific antidote for paraquat poison. ARDS, acute kidney injury with metabolic acidosis or multi-organ failure are the frequent causes of mortality.Methods: The study aimed to study the morbidity and mortality rates of Paraquat poisoning in tertiary care teaching hospital. Patients admitted with Paraquat poisoning were included, and the data were collected and analysed.Results: The total number of cases admitted with paraquat poisoning in intensive care unit in three years duration were 10. All the cases were suicidal in nature. 80% of the cases had acute kidney injury with severe metabolic acidosis and 20% had mediastinitis. 70% of cases died within 48 hours of ingestion. The overall mortality rate was 100% in spite of active management.Conclusions: Of all registered herbicides, Paraquat is the most serious and life threatening. Inspite of early haemodialysis, steroids and cyclophosphamide therapy, it was ineffective in reducing the mortality rates. Newer treatment like early hemoperfusion may help to reduce the mortality in future.

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