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논문분류	춘계학술대회 초록집
제목	Acute kidney injury following ingestion of oxalic acid (H2C2O4) and potassium permanganate (KMnO4) – A review
저자	Thilini Wijerathna, Dhammika Dissanayaka
출판정보	2019; 2019(1):
키워드	Acute kidney injury \| oxalic acid \| potassium permanganate
초록	Intentional self-poisoning with a laundry detergent containing oxalic acid (H2C2O4) and potassium permanganate (KMnO4) is a significant medical problem in Sri Lanka. Hospital admissions for poisoning have increased over the last ten years. Acute kidney injury (AKI) is a frequent consequence. Through this review, we intended to gather information on kidney injury as a clinical manifestation following H2C2O4 and KMnO4 poisoning. We have reviewed case reports and articles following intentional self-poisoning with H2C2O4 and KMnO4 using the following data sources: Pubmed, papers cited in publications retrieved and the worldwide web (using google). 352 patient’s data reported in the literature. 34 died. Of 157 patients whose serum creatinine (sCr) data available, 113 developed AKI. Highest reported sCr was 7.04 mg/dl. Of 181 patients who had clinical monitoring data, vomiting, abdominal pain, back pain and oliguria reported as consequences of AKI. Nineteen received or needed dialysis. Renal biopsy indicated tubulointerstitial nephritis/acute tubular damage. Calcium oxalate crystals observed. Fifteen patients showed kidney congestion. Post mortem findings of 16 patients revealed swollen kidneys. Increased levels of urinary albumin, clusterin, neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1) and osteopontin observed in 63 patients who had AKI according to acute kidney injury network (AKIN) criteria. Ingestion of H2C2O4 and KMnO4 developed varying degress of AKI from mild to severe. Deposition of oxalate crystals in the tubular epithelium was the main cause of AKI. Distal and proximal tubular damage were more common.
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