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논문분류	춘계학술대회 초록집
제목	Early and Rapid Rise of Creatinine following ingestion of Combined Washing Powder (mixture of Potassium permanganate and Oxalic Acid) in Sri Lanka is not due to direct Nephrotoxicty
저자	Thilini Wijerathna* 1, 2, Indika Gawarammana1, 3, Dhammika Dissanayaka2, Nick Buckeley4
출판정보	2016; 2016(1):
키워드	Acute kidney injury, Oxalic acid, Potassium permanganate
초록	Background: Acute Kidney Injury (AKI) is a common clinical manifestation following self poisoning with combined washing powder (CWP) containing potassium permanganate (KMnO4) and oxalic acid (H2C2O4) in Sri Lanka. In a multicentre cohort study, we noted early and rapid increment of serum creatinine (sCr) in patients with CWP poisoning. This study was designed to investigate if this rise was due to direct nephrotoxicity. Methods: Forty Eight patients with CWP poisoning whose both sCr and serum cystatinC (sCysC) data available were selected to the study. Kinetics of sCr and serum sCysC were compared. Results: Thirty nine (81%) patients developed AKI (AKIN criteria). 29 (74%) developed severe AKI (AKIN 2 or 3). Severe AKI group had rapid increase in serum Cr by > 120% at 24 hours, >150% at 48 hours and >350% at 72 hours post ingestion. Comparative rise of sCysC was < 50% till 48 hours and increased to only 50% at 72 hours. Conclusion: Ingestion of CWP cased AKI. Elevation of sCr occurred earlier than sCysC. The rapid and early rise of sCr in CWP poisoning is multifactorial. Main mechanism appears to be due to increased production of creatine and creatinine to meet the energy demands following severe oxidative stress mediated by KMnO4 and Oxalic Acid.
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