International Journal of Medical Toxicology and Forensic Medicine (Nov 2020)
Acute Kidney Injury in Poisoned Patients Admitted to ICU
Abstract
Background: Acute Kidney Injury (AKI) is an abrupt decrease in kidney function, leading to the retention of urea and other nitrogenous waste products. Poisoned patients admitted to the Intensive Care Unit (ICU) may develop AKI due to some reasons. This study was done to evaluate the AKI in poisoned patients admitted to ICU. Methods: 146 patients, admitted to the ICU of Imam Reza Hospital from March 2017 to March 2018 were studied. AKI status was assessed using Acute Kidney Injury Network (AKIN) and Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE) classification. Data analysis was done through SPSS V. 22 software. Results: Opioids, organophosphates, aluminum phosphide, multiple drugs, and other types of poisoning were the main five poisoning classes. Opioid toxicity was had the highest frequency with 51 patients; cases in this group experienced longer length of hospitalization stay and higher serum creatinine level than others did. Among 146 patients, 19 patients (12.8%) died, and 97 patients (66%) were transferred to the ICU. Of all cases, 18 patients (12.3%) had renal dysfunction (six patients were at risk, five patient at injury, and seven patients were at failure phase based on the RIFLE criteria). Renal replacement therapy was required in 24 cases (16.4%). Conclusion: It is unlikely to detect a significant difference in the occurrence of AKI between the main poisoning classes. Being the largest group of intoxicated patients admitted to the ICU, the opioid poisoning had the highest rate of AKI
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