Acetaminophen poisoning. The epidemic of liver injury seen in hospitals today is thought to be due to high use of acetaminophen by all of us. Changes in liver function has been documented following just a therapeutic dose in some people. Liver transplants and death have also been widely reported following both acute and chronic ingestion of acetaminophen.
But that is not the whole story. There is a group of patients that also suffer kidney damage secondary to acetaminophen poison. It is known that the kidney contains some of the same enzymes that in the liver change a small portion of acetaminophen into a toxic metabolite. And when following a large acute overdose renal toxicity is something that needs to be monitored. But how frequent is renal toxicity noted in patients with acetaminophen poisoning? In a study published last year (Nephro Dialysis Transplantation 2011; 26(11):3501-08) only 21 % of patients that were inpatients in an intensive care unit with liver toxicity due to acetaminophen did NOT develop renal toxicity. The over whelming majority had some level of kidney impairment. Most of those patients did recover kidney function. But a small percentage of patients develop chronic kidney failure.
Being aware of acetaminophen induced hepatic damage is very important for all of us. But don't forget the kidney, it is another organ that we should worry about.
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