Paint-thinner-induced Acute Kidney Injury: A Case Series and Review
Occupational health hazards contribute significantly to the morbidity and mortality of workers in factories. Toluene has become a widely abused inhaled volatile drug. The spectrum of toluene-induced renal injury includes rhabdomyolysis, myoglobinemia, distal renal tubular acidosis (RTA), acute tubul...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Saudi Journal of Kidney Diseases and Transplantation |
| Online Access: | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2022;volume=33;issue=3;spage=487;epage=491;aulast=Latief |
| _version_ | 1797645355623383040 |
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| author | Muzamil Latief Zhahid Hassan Obeid Shafi Farhat Abbas Summyia Farooq |
| author_facet | Muzamil Latief Zhahid Hassan Obeid Shafi Farhat Abbas Summyia Farooq |
| author_sort | Muzamil Latief |
| collection | DOAJ |
| description | Occupational health hazards contribute significantly to the morbidity and mortality of workers in factories. Toluene has become a widely abused inhaled volatile drug. The spectrum of toluene-induced renal injury includes rhabdomyolysis, myoglobinemia, distal renal tubular acidosis (RTA), acute tubular necrosis, glomerulonephritis, and interstitial nephritis. We describe two patients with paint-thinner-induced kidney injury who were affected through different routes of exposure and recovered well, with one requiring dialysis support; the second patient, who had developed Type 1 distal RTA and mild kidney injury, was managed with conservative measures. Toluene can cause acute neurological symptoms, accompanied by severe metabolic alterations, as well as organ injury and dysfunction. A common association of the development of hypokalemic paralysis and metabolic acidosis with toluene intoxication was observed. Liver injury and rhabdomyolysis are also common. Vomiting, dehydration, tubular injury, and rhabdomyolysis are all possible additional causes of acute renal failure in toluene intoxication. Type 1 distal RTA, which is characterized by an inability to lower urine pH despite acidemia, results in hyperchloremic metabolic acidosis with hypokalemia. The management of acute toluene toxicity is largely conservative, consisting of correcting the electrolytes and the acid–base balance, fluid alterations, and renal replacement therapy in severe acute kidney injury. A clinical suspicion of organ failure and prompt supportive care leads to encouraging results. Adequate protective steps for workplaces involved in the use of such substances in confined spaces include prior risk assessment, using low-toxicity chemical products, ensuring adequate ventilation, safety training, and using appropriate personal protective equipment. |
| first_indexed | 2024-03-11T14:45:07Z |
| format | Article |
| id | doaj.art-34e5e1c209bb46bd9e5b22e7e63a3e70 |
| institution | Directory Open Access Journal |
| issn | 1319-2442 |
| language | English |
| last_indexed | 2024-03-11T14:45:07Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Kidney Diseases and Transplantation |
| spelling | doaj.art-34e5e1c209bb46bd9e5b22e7e63a3e702023-10-30T11:57:41ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422022-01-0133348749110.4103/1319-2442.385970Paint-thinner-induced Acute Kidney Injury: A Case Series and ReviewMuzamil LatiefZhahid HassanObeid ShafiFarhat AbbasSummyia FarooqOccupational health hazards contribute significantly to the morbidity and mortality of workers in factories. Toluene has become a widely abused inhaled volatile drug. The spectrum of toluene-induced renal injury includes rhabdomyolysis, myoglobinemia, distal renal tubular acidosis (RTA), acute tubular necrosis, glomerulonephritis, and interstitial nephritis. We describe two patients with paint-thinner-induced kidney injury who were affected through different routes of exposure and recovered well, with one requiring dialysis support; the second patient, who had developed Type 1 distal RTA and mild kidney injury, was managed with conservative measures. Toluene can cause acute neurological symptoms, accompanied by severe metabolic alterations, as well as organ injury and dysfunction. A common association of the development of hypokalemic paralysis and metabolic acidosis with toluene intoxication was observed. Liver injury and rhabdomyolysis are also common. Vomiting, dehydration, tubular injury, and rhabdomyolysis are all possible additional causes of acute renal failure in toluene intoxication. Type 1 distal RTA, which is characterized by an inability to lower urine pH despite acidemia, results in hyperchloremic metabolic acidosis with hypokalemia. The management of acute toluene toxicity is largely conservative, consisting of correcting the electrolytes and the acid–base balance, fluid alterations, and renal replacement therapy in severe acute kidney injury. A clinical suspicion of organ failure and prompt supportive care leads to encouraging results. Adequate protective steps for workplaces involved in the use of such substances in confined spaces include prior risk assessment, using low-toxicity chemical products, ensuring adequate ventilation, safety training, and using appropriate personal protective equipment.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2022;volume=33;issue=3;spage=487;epage=491;aulast=Latief |
| spellingShingle | Muzamil Latief Zhahid Hassan Obeid Shafi Farhat Abbas Summyia Farooq Paint-thinner-induced Acute Kidney Injury: A Case Series and Review Saudi Journal of Kidney Diseases and Transplantation |
| title | Paint-thinner-induced Acute Kidney Injury: A Case Series and Review |
| title_full | Paint-thinner-induced Acute Kidney Injury: A Case Series and Review |
| title_fullStr | Paint-thinner-induced Acute Kidney Injury: A Case Series and Review |
| title_full_unstemmed | Paint-thinner-induced Acute Kidney Injury: A Case Series and Review |
| title_short | Paint-thinner-induced Acute Kidney Injury: A Case Series and Review |
| title_sort | paint thinner induced acute kidney injury a case series and review |
| url | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2022;volume=33;issue=3;spage=487;epage=491;aulast=Latief |
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