Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 665 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 
 


 
Table of Contents   
LETTER TO THE EDITOR  
Year : 2013  |  Volume : 24  |  Issue : 3  |  Page : 592-593
Acute kidney injury in Endosulfan poisoning


Department of Nephrology, Srivenkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Click here for correspondence address and email

Date of Web Publication24-Apr-2013
 

How to cite this article:
Yadla M, Yanala SR, Parvithina S, Chennu KK, Annapindi N, Vishnubhotla S. Acute kidney injury in Endosulfan poisoning. Saudi J Kidney Dis Transpl 2013;24:592-3

How to cite this URL:
Yadla M, Yanala SR, Parvithina S, Chennu KK, Annapindi N, Vishnubhotla S. Acute kidney injury in Endosulfan poisoning. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2019 Feb 23];24:592-3. Available from: http://www.sjkdt.org/text.asp?2013/24/3/592/111077
To the Editor,

Endosulfan belongs to the cyclodiene class of organochlorine group of pesticides. In view of high efficacy, low cost and environmental sta­bility, it is one of the widely used agricultural pesticides despite its life-threatening toxic ef­fects, especially in the developing countries. [1] It is often reported to produce acute toxicity involving the central nervous system, manifes­ting in the form of seizures. It can also cause rhabdomyolysis, metabolic acidosis, hypoten­sion and respiratory failure. However, litera­ture regarding acute kidney injury is sparse. [2] Human exposure may be occupational, acci­dental or suicidal. Ingestion of 35% Endosulfan (35 g in 100 mL) is considered lethal in humans. [3]

The occurrence of acute kidney injury has been attributed to rhabdomyolysis and hypotension. [1],[3] Direct toxicity on renal tubule re­sulting in acute tubular necrosis is also cited. [2] Acute kidney injury needing dialysis support is reported to be associated with high mor­bidity and mortality. [1],[2] We report a patient of Endosulfan poisoning with acute kidney injury who had a successful outcome with hemodialysis support.

A young man aged 28 years presented to the emergency department with a history of in­gestion of an unknown quantity of Endosulfan on the same day. Our patient presented with central nervous system manifestations in the form of seizures and altered sensorium. At presentation, his blood pressure was 160/60 mmHg. His urine output was 900 mL. Evalua­tion revealed renal failure (serum creatinine: 8.4 mg/dL, serum potassium: 4.6 meq/L) with compensated metabolic acidosis (pH: 7.38 serum bicarbonate: 15.8 meq/L) and rhabdomyolysis (serum creatine phosphokinase: 15700 IU/L). Liver function tests were within normal limits. In view of severe renal failure, he was supported with hemodialysis. After three sessions, his urine output increased to 2.5 L/day and his serum creatinine decreased to 3.7 mg/dL. At discharge, his serum creatinine was 2.7 mg/dL.

In our case, we suspect the cause of acute kidney injury to be:

  1. Rhabdomyolysis.
  2. Direct toxic effect on renal tubules causing acute tubular necrosis.
Uncommon occurrence and successful out­come are the points of interest in our case.

 
   References Top

1.Moon JM, Chun BJ. Acute endosulfan poiso­ning: A retrospective study. Hum Exp Toxicol 2009;28:309-16.  Back to cited text no. 1
    
2.Lo RS, Chan JC, Cockram CS, Lai FM. Acute tubular necrosis following endosulfan insec­ticide poisoning. J Toxicol Clin Toxicol 1995; 33:67-9.   Back to cited text no. 2
    
3.Moses V, Peter JV. Acute intentional toxicity: Endosulfan and other organochlorines. Clin Toxicol (Phila) 2010;48:539-44.  Back to cited text no. 3
    

Top
Correspondence Address:
Manjusha Yadla
Department of Nephrology, Srivenkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh
India
Login to access the Email id


DOI: 10.4103/1319-2442.111077

PMID: 23640641

Rights and Permissions




 

Top
   
 
 
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  
 


 
    References
 

 Article Access Statistics
    Viewed1079    
    Printed31    
    Emailed0    
    PDF Downloaded325    
    Comments [Add]    

Recommend this journal