Oncotarget

Research Papers:

Predictors of acute kidney injury after paraquat intoxication

Cheng-Hao Weng, Hui-Hsiang Chen, Ching-Chih Hu, Wen-Hung Huang, Ching-Wei Hsu, Jen-Fen Fu, Wey-Ran Lin, I-Kwan Wang and Tzung-Hai Yen _

PDF  |  HTML  |  How to cite  |  Order a Reprint

Oncotarget. 2017; 8:51345-51354. https://doi.org/10.18632/oncotarget.17975

Metrics: PDF 630 views  |   HTML 1233 views  |   ?  


Abstract

Cheng-Hao Weng1,*, Hui-Hsiang Chen1,*, Ching-Chih Hu2, Wen-Hung Huang1, Ching-Wei Hsu1, Jen-Fen Fu3, Wey-Ran Lin4, I-Kwan Wang5 and Tzung-Hai Yen1,6,7

1Department of Nephrology and Poison Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan

2Department of Hepatogastroenterology and Liver Research Unit, Chang Gung Memorial Hospital, Keelung, Taiwan

3Department of Medical Research, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan

4Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan

5Department of Nephrology, Chang Medical University Hospital and College of Medicine, China Medical University, Taichung, Taiwan

6Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan

7Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan

*These authors contributed equally to this work

Correspondence to:

Tzung-Hai Yen, email: m19570@adm.cgmh.org.tw

Keywords: paraquat, suicide, acute kidney injury, SOFA, AKIN

Received: March 14, 2017     Accepted: May 07, 2017     Published: May 18, 2017

ABSTRACT

Paraquat intoxication is characterized by multi-organ failure, causing substantial mortality and morbidity. Many paraquat patients experience acute kidney injury (AKI), sometimes requiring hemodialysis. We observed 222 paraquat-intoxicated patients between 2000 and 2012, and divided them into AKI (n = 103) and non-AKI (n = 119) groups. The mortality rate was higher for AKI than non-AKI patients (70.1% vs. 40.0%, P < 0.001). Patients with AKI had a longer time to hospital arrival (P = 0.003), lower PaO2 (P = 0.006) and higher alveolar-arterial O2 difference (P < 0.001) 48 h after admission, higher sequential organ failure assessment 48-h score (P < 0.001), higher severity index of paraquat poisoning (SIPP) score (P = 0.016), lower PaCO2 at admission (P = 0.031), higher PaO2 at admission (P = 0.015), lower nadir PaCO2 (P = 0.001) and lower nadir HCO3 (P = 0.004) than non-AKI patients. Multivariate logistic regression indicated that acute hepatitis (P < 0.001), a longer time to hospital arrival (P < 0.001), higher SIPP score (P = 0.026) and higher PaO2 at admission (P = 0.014) were predictors of AKI. The area under the receiver operating characteristic curve confirmed that an Acute Kidney Injury Network 48-hour score ≥ 2 predicted AKI necessitating hemodialysis with a sensitivity of 0.6 and specificity of 0.832. AKI is common (46.4%) following paraquat ingestion, and acute hepatitis, the time to hospital arrival, SIPP score and PaO2 at admission were powerful predictors of AKI. Larger studies with longer follow-up durations are warranted.


Creative Commons License All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License.
PII: 17975