Title |
Acetaminophen-induced nephrotoxicity: Pathophysiology, clinical manifestations, and management
|
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Published in |
Journal of Medical Toxicology, March 2008
|
DOI | 10.1007/bf03160941 |
Pubmed ID | |
Authors |
Maryann Mazer, Jeanmarie Perrone |
Abstract |
Acetaminophen-induced liver necrosis has been studied extensively, but the extrahepatic manifestations of acetaminophen toxicity are currently not described well in the literature. Renal insufficiency occurs in approximately 1-2% of patients with acetaminophen overdose. The pathophysiology of renal toxicity in acetaminophen poisoning has been attributed to cytochrome P-450 mixed function oxidase isoenzymes present in the kidney, although other mechanisms have been elucidated, including the role of prostaglandin synthetase and N-deacetylase enzymes. Paradoxically, glutathione is considered an important element in the detoxification of acetaminophen and its metabolites; however, its conjugates have been implicated in the formation of nephrotoxic compounds. Acetaminophen-induced renal failure becomes evident after hepatotoxicity in most cases, but can be differentiated from the hepatorenal syndrome, which may complicate fulminant hepatic failure. The role of N-acetylcysteine therapy in the setting of acetaminophen-induced renal failure is unclear. This review will focus on the pathophysiology, clinical features, and management of renal insufficiency in the setting of acute acetaminophen toxicity. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Australia | 3 | 21% |
Canada | 2 | 14% |
Japan | 1 | 7% |
Saudi Arabia | 1 | 7% |
India | 1 | 7% |
Unknown | 6 | 43% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 9 | 64% |
Scientists | 3 | 21% |
Practitioners (doctors, other healthcare professionals) | 2 | 14% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | <1% |
Bangladesh | 1 | <1% |
Ireland | 1 | <1% |
Malaysia | 1 | <1% |
Mexico | 1 | <1% |
Sri Lanka | 1 | <1% |
Unknown | 317 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 45 | 14% |
Student > Bachelor | 44 | 14% |
Student > Ph. D. Student | 30 | 9% |
Other | 24 | 7% |
Researcher | 22 | 7% |
Other | 61 | 19% |
Unknown | 98 | 30% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 95 | 29% |
Pharmacology, Toxicology and Pharmaceutical Science | 39 | 12% |
Agricultural and Biological Sciences | 18 | 6% |
Biochemistry, Genetics and Molecular Biology | 15 | 5% |
Chemistry | 11 | 3% |
Other | 39 | 12% |
Unknown | 107 | 33% |