Acute kidney injury due to intravenous detergent poisoning:A case report

作     者：Sungbin Park Hyun-Sik Ryu Jae-Kwang Lee Sung-Soo Park Sun-Jung Kwon Won-Min Hwang Sung-Ro Yun Moon-Hyang Park Yohan Park 

作者机构：Department of Internal MedicineDivision of NephrologyKonyang University HospitalCollege of MedicineDaejeon 35365South Korea Department of Emergency MedicineKonyang University HospitalCollege of MedicineDaejeon 35365South Korea Department of Internal MedicineDivision of Respiratory and Critical Care MedicineKonyang University HospitalCollege of MedicineDaejeon 35365South Korea Department of PathologyKonyang University HospitalCollege of MedicineDaejeon 35365South Korea 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2022年第10卷第6期

页      面：2036-2044页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Detergents Poisoning Intravenous injection Acute kidney injury Acute tubular injury Case report 

摘      要：BACKGROUND Detergent poisoning mostly occurs through oral ingestion(85%),ocular exposure(15%),or dermal exposure(8%).Reports of detergent poisoning through an intravenous injection are extremely rare.In addition,there are very few cases of renal toxicity directly caused by detergents.Here,we report a unique case of acute kidney injury caused by detergent poisoning through an accidental intravenous injection.CASE SUMMARY A 61-year-old man was intravenously injected with 20 mL of detergent by another patient in the same room of a local hospital.The surfactant and calcium carbonate accounted for the largest proportion of the detergent.The patient complained of vascular pain,chest discomfort,and nausea,and was transferred to our institution.After hospitalization,the patient’s serum creatinine level increased to 5.42 mg/dL,and his daily urine output decreased to approximately 300 mL.Renal biopsy findings noted that the glomeruli were relatively intact;however,diffuse acute tubular injury was observed.Generalized edema was also noted,and the patient underwent a total of four hemodiafiltration sessions.Afterward,the patient’s urine output gradually increased whereas the serum creatinine level decreased.The patient was discharged in a stable status without any sequelae.CONCLUSION Detergents appear to directly cause renal tubular injury by systemic absorption.In treating a patient with detergent poisoning,physicians should be aware that the renal function may also deteriorate.In addition,timely renal replacement therapy may help improve the patient’s prognosis.