Pseudorenal Insufficiency With Isopropyl Alcohol Ingestion

Killeen, Colin; Meehan, Tim; Dohnal, James C.; Leikin, Jerrold B.

doi:10.1097/mjt.0b013e3181c960cb

Cited by 11 publications

(3 citation statements)

References 12 publications

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“…Our patient's serum creatinine was elevated after the ingestion and continued to rise, indicating acute kidney injury, but false elevations have been observed with isopropanol toxicity. 21 Her renal function eventually returned to baseline.…”

Section: Discussionmentioning

confidence: 93%

Intentional ingestion of hand sanitizer in an adult psychiatric unit

Stevens¹,

Hix²

2020

Mental Health Clinician

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Intentional ingestion of ethanol- or isopropanol-based hand sanitizer has been reported in the literature in a variety of settings within the health care system. Specifically in psychiatric units, case reports have only described ingestion of ethanol-based products. This report describes a case of intentional ingestion of isopropanol-based hand sanitizer by a patient while hospitalized on a psychiatric unit. The patient developed acute respiratory failure, acute kidney injury, and metabolic encephalopathy and was treated for 3 days in the intensive care unit before returning to the psychiatric unit. This case highlights the process of identifying suspected ingestion while hospitalized. In any patient who has a sudden change in level of consciousness, clinicians should consider the potential for ingestion of ethanol- or isopropanol-based hand sanitizer. Facilities should be aware of how accessible hand sanitizer is, particularly in areas with patients who have a history of substance dependence.

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Section: Discussionmentioning

confidence: 93%

Intentional ingestion of hand sanitizer in an adult psychiatric unit

Stevens¹,

Hix²

2020

Mental Health Clinician

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“…For example, urine output would be inaccurate if there is a blockage in the urinary system or the urine collecting system; isopropyl alcohol intoxication may affect some of the creatinine assays. 19 Nevertheless, these confounding factors would affect the accuracy of KDIGO AKI definition and kinetic GFR also.…”

Section: Discussionmentioning

confidence: 99%

Direct Measurement of Creatinine Clearance over a Short Interval in Intensive Care Settings

Law¹,

Lo²,

Yeoh³

2021

Indian Journal of Critical Care Medicine

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A bstract Background The definition of acute kidney injury (AKI), based on serum creatinine and urine output, bears significant limitations in intensive care units (ICUs). Serum creatinine has significant lag-time as it needs to be accumulated and stabilized at a new level whereas urine output is affected by diuresis, antidiuresis, and antinatriuresis. Direct measurement of creatinine clearance (CrCl direct = urine creatinine × urine flow rate/serum creatinine) over a short interval (3–6 hours) was explored to identify patients with AKI. Materials and methods We reanalyzed a previous published dataset. We included 11 patients who had serial daily urine collections over 0 to 3 days of stay in ICU and baseline (day -1) serum creatinine levels. Result The ratio of CrCl direct on day 0 to baseline creatinine clearance predicted the progression of AKI over the subsequent 1 to 3 days of ICU stay [area under receiver operating characteristic curve = 0.933 and 95% confidence interval (CI) = 0.780–1.000]. Discussion CrCl direct over a short interval may be an alternative marker of kidney function. Future studies may explore its use to identify patients with AKI who may benefit from early renal replacement therapy. How to cite this article Law LSC, Lo EAG, Yeoh SF. Direct Measurement of Creatinine Clearance over a Short Interval in Intensive Care Settings. Indian J Crit Care Med 2021;25(7):800–802.

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“…The reason for this lies in the liver metabolism of isopropyl alcohol by alcohol-dehydrogenase to acetone and none of its metabolites are organic acids. Moreover, acetone can cause laboratory assay interference in the determination of serum creatinine concentration giving a pseudorenal failure laboratory picture [85].…”

Section: Environmental (Agri)chemical Nephrotoxicitymentioning

confidence: 99%

Acute toxic kidney injury

et al. 2019

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Substances toxic to the kidney are legion in the modern world. The sheer number and variety, their mutual interactions and, metabolism within the body are a challenge to research. Moreover, the kidney is especially prone to injury owing to its physiology. Acute kidney injury (AKI) induced by poisonous or primarily nephrotoxic substances, may be community acquired with ingestion or inhalation or nosocomial. Many nephrotoxic plants, animal poisons, medications, chemicals and illicit drugs can induce AKI by varying pathophysiological pathways. Moreover, the epidemiology of toxic AKI varies depending on country, regions within countries, socioeconomic status and health care facilities. In this review, we have selected nephrotoxic insults due to medication, plants, animal including snake venom toxicity, environmental, (agri)chemicals and also illicit drugs. We conclude with a section on diagnosis, clinical presentation and management of poisoning accompanied by various organ dysfunction and AKI.

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Pseudorenal Insufficiency With Isopropyl Alcohol Ingestion

Cited by 11 publications

References 12 publications

Intentional ingestion of hand sanitizer in an adult psychiatric unit

Intentional ingestion of hand sanitizer in an adult psychiatric unit

Direct Measurement of Creatinine Clearance over a Short Interval in Intensive Care Settings

Acute toxic kidney injury

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