Hepatic and renal damage after acute poisonings

Authors: M. Mydlík;  K. Derzsiová
Authors‘ workplace: Nefrologická klinika Lekárskej fakulty UPJŠ a FN L. Pasteura, Košice, Slovenská republika, prednosta MUDr. A. Rajnič, Ph. D.
Published in: Vnitř Lék 2005; 51(6): 671-675
Category: Original Contributions


In the paper the analysis of concomitant damage of liver and kidneys after acute tetrachloromethane poisoning in 60 patients, after mushroom poisoning (Amanita phalloides) in 81 patients and after ethyleneglycol poisoning in 20 patients from the view of differential diagnosis, conservative and extracorporeal elimination treatment is described. Acute toxic hepatitis with the different degree of severity was present in all patients and even acute renal failure was present in some patients. After acute tetrachloromethane poisoning acute hepatitis developed approximately simultaneously with the development of acute renal failure. After acute Amanita phalloides poisoning acute toxic hepatitis, which was the cause of death in hepatic coma in 16 patients, quickly developed in the foreground of the clinical picture. Renal damage was less frequent and it was not the cause of death even in one patient. After acute ethyleneglycol poisoning acute renal failure dominated with severe metabolic acidosis, oxaluria and leukocytosis, acute toxic hepatitis was less severe. After ethyleneglycol poisoning 3 patients died in the period before the use of the bicarbonate hemodialysis was possible. During 30 years the extracorporeal elimination treatment qualitatively developed (bicarbonate hemodialysis, hemoperfusion through activated charcoal and other sorbents, plasmapheresis, hemofiltration), which participates to the significant degree on the recovery and improvement of the prognosis of patients after acute poisonings with concomitant damage of liver and kidneys.

Key words:
acute poisoning – tetrachloromethane – mushrooms (Amanita phalloides) – ethyleneglycol – hepatic and renal damage – extracorporeal elimination treatment


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