Insuffisance rénale aiguë secondaire à la povidone iodée: à propos d'un cas clinique

Moudden, Mohamed Karim; Labaye, Jacques; Sarret, Damien; Cazajous, G.; Herody, M.; Didelot, F.

doi:10.1016/j.revmed.2007.04.006

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…To our knowledge, there are three cases similar to ours, in the literature, with systemic absorption emerging immediately post uterine instillation [8][9][10], reported in 2006, 2007, and 2011.…”

Section: Figure 1: Computed Tomography (Ct) Scan Of the Chest And Abd...supporting

confidence: 76%

“…We report a case of a young adult woman who developed PI-induced AKI, after a diagnostic hysteroscopy and laparoscopy procedure in terms of infertility evaluation. To our knowledge, this is the first case of PIinduced AKI in the Republic of Cyprus, and one of the few [8][9][10] in the published literature associated with a gynecology procedure.…”

Section: Introductionmentioning

confidence: 79%

“…Its use is common practice as a skin disinfectant, especially in surgery preparation, but it is also being used for burn patients, in deep wound treatment, for surgical wound irrigation [13][14][15][16][17][18][19], for intracavity lavage in abdominal operations [20,21] as well as for chemical pleurodesis [22] and mediastinal irrigation in cases of mediastinitis [4,5,23,24]. It has also been used for recurrent lymphocele sclerosis [6] and a couple of gynecological indications [7][8][9][10], like in our case, as a dye for imaging hydrotubation. More recently, it has been tested as a potential anti-cancer agent against various cell lines in vivo, including malignant pleural mesothelioma, colorectal cancer, breast and lung carcinoma, and melanoma [25][26][27][28].…”

Section: Figure 1: Computed Tomography (Ct) Scan Of the Chest And Abd...mentioning

confidence: 99%

“…Experimental data raise concern that iodine toxicity could follow peritoneal lavage in peritonitis, although this has not been reported in humans [35,36]. Moreover, toxicity pertains to acute kidney injury, presenting with metabolic acidosis, hyperosmolality, and hypernatraemia [6,[8][9][10]16,23,33]. Despite that PIinduced AKI is a common cause of in-hospital renal dysfunction, its pathophysiology has not yet been understood completely [37].…”

Section: Figure 1: Computed Tomography (Ct) Scan Of the Chest And Abd...mentioning

confidence: 99%

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Povidone-Iodine-Induced Acute Kidney Injury in a 23-Year-Old Woman: The First Clinical Case Report From the Republic of Cyprus

Papadopoulos¹,

Iordanou²,

Georgiou³

et al. 2022

Cureus

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Povidone-iodine (PI) is considered a generally safe broad-spectrum, antiseptic substance, which is widely used in healthcare services, mostly for burn patients, in wound treatment, surgical wound irrigation, as well as for a few gynecological indications. Although it is safe, its use on mucosa can cause toxicity due to iodine absorption and the high concentration in the serum. PI toxicity is absorption depended and has been associated with severe adverse events including acute kidney injury (AKI). To our knowledge, there are only three cases of PI-induced AKI after uterine instillation in the published literature. We report a case of severe PI-induced AKI that occurred in a 23-year-old female due to iodine systemic absorption immediately post uterine instillation, in terms of infertility evaluation.The patient was admitted to the intensive care unit (ICU), supported with mechanical ventilation and treated with renal replacement therapy (RRT). Renal function and urine output improved and the patient was discharged from ICU.Severe adverse events may be linked to internal use, therefore, PI on mucosa should be used with extreme caution. Clinicians should be aware of iodine intoxication and possible AKI.

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Section: Figure 1: Computed Tomography (Ct) Scan Of the Chest And Abd...supporting

confidence: 76%

Section: Introductionmentioning

confidence: 79%

Section: Figure 1: Computed Tomography (Ct) Scan Of the Chest And Abd...mentioning

confidence: 99%

Section: Figure 1: Computed Tomography (Ct) Scan Of the Chest And Abd...mentioning

confidence: 99%

See 2 more Smart Citations

Povidone-Iodine-Induced Acute Kidney Injury in a 23-Year-Old Woman: The First Clinical Case Report From the Republic of Cyprus

Papadopoulos¹,

Iordanou²,

Georgiou³

et al. 2022

Cureus

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“…Indeed, a recent experimental study showed that povidone-iodine exposure induced time- and concentration-dependent apoptosis and necrosis in cultured human epithelial cells and rat oral mucosal tissue. [ 9 ] AKI may be accompanied by metabolic acidosis, anemia, or hypernatremia [ 2 , 6 , 10 , 11 ] ; our patient presented with AKI and anemia, but showed no definite metabolic acidosis or hypernatremia.…”

Section: Discussionmentioning

confidence: 79%

Acute kidney injury due to povidone-iodine ingestion

Kim¹,

Kim

Bae³

et al. 2017

Medicine

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Rationale:Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described.Patient concerns:A 47-year-old man who had apparently ingested povidone-iodine solution and presented with nausea, vomiting, and reduced urine output. Laboratory data revealed blood urea nitrogen of 124 mg/dL, serum creatinine of 6.3 mg/dL, impaired liver function, and leukocytosis. Urine iodine/creatinine ratio was markedly elevated.Diagnoses:Acute tubular necrosis and interstitial nephritis secondary to povidone-iodine ingestion.Interventions:The patient was admitted to the intensive care unit and underwent continuous venovenous hemodiafiltration. Kidney biopsy showed acute tubular necrosis and interstitial nephritis. Unstained sections showed tan objects in the tubular lumina that were suspected to be povidone-iodine casts. Corticosteroid therapy (1 mg/kg/day) was started after kidney biopsy.Outcomes:Renal function recovered after hemodialysis and corticosteroid medication, but not completely.Lessons:We have reported the first case of biopsy-confirmed AKI accompanied by increased urine iodine concentration following povidone-iodine ingestion.

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