Acute kidney injury and the risk of mortality in patients with methanol intoxication

Abstract

Background Methanol poisoning is a serious public health issue in developing countries, but few data are available in the literature on acute kidney injury (AKI) after methanol intoxication. Methods This study examined the clinical features, spectrum and outcomes of AKI in patients with methanol intoxication and evaluated the predictors of mortality after methanol intoxication. A total of 50 patients with methanol intoxication were seen at Chang Gung Memorial Hospital between 2000 and 2013. Patients were grouped according to the status of renal damage as AKI ( n = 33) or non-AKI ( n = 19). Demographic, clinical, laboratory, and mortality data were obtained for analysis. Results Most patients were middle-aged (47.8 ± 14.9 years), predominantly male (74.0%), and habitual alcohol consumers (70.0%). Most incidents were oral exposures (96.0%) and unintentional (66.0%). Two (4.0%) patients attempted suicide by intravenous injection of methanol. Five (10.0%) patients suffered methanol intoxication after ingestion of methomyl pesticide that contained methanol as a solvent. Compared to non-AKI patients, the AKI patients were older (50.9 ± 13.7 versus 41.6 ± 15.6 years, P = 0.034), predominantly male (90.9% versus 42.8%, P = 0.000), more habitual alcohol users (84.8% versus 41.2%, P = 0.001) and had more unintentional exposures (82.8% versus 35.3%, P = 0.001). Furthermore, there was a higher incidence of respiratory failure (63.6% versus 29.4%, P = 0.022) in the AKI group than in the non-AKI group, respectively. The laboratory studies revealed that the AKI patients suffered from more severe metabolic acidosis than the non-AKI patients. By the end of this study, 13 (39.5%) AKI patients and 1 (5.9%) non-AKI patient had died. The overall in-hospital hospital mortality rate was 28%. In a multivariate binary logistic regression model, it was demonstrated that AKI (odds ratio 19.670, confidence interval 1.026–377.008, P = 0.048) and Glasgow coma scale score (odds ratio 1.370, confidence interval 1.079–1.739, P = 0.010) were significant factors associated with mortality. The Kaplan-Meier analysis disclosed that AKI patients suffered lower cumulative survival than non-AKI patients (log-rank test, chi-square = 5.115, P = 0.024). Conclusions AKI was common (66.0%) after methanol intoxication and was predictive of in-hospital hospital mortality. The development of AKI was associated with a 19.670-fold higher risk of in-hospital mortality.

Useful Electrocardiographic and Laboratory Findings in Shiraz Outbreak of 356 Methanol Poisoned Patients

“…To the best of our knowledge, this is the rst study on the association between comprehensive analysis of electrocardiographic ndings and mortality in methanol toxicity with a considerable sample size. The mortality rate in this study was 16.6% which is comparable with various published data [4,13,14]. Furthermore, the mortality rate was higher among female patients and patients aged above 40 years.…”

“…As expected, patients with a past history of cardiac diseases showed a higher mortality rate. Moreover, the results further highlighted the correlation between the development of complications such as blindness and renal problems and increased morbidity and mortality, which is in line with previous evidences [13,14].…”

“…There is a literature gap in literature on methanol poisoning is the rarity of such outbreaks and the small number of the reported cases. In addition, very little is known about the electrographic ndings as risk factors leading to mortality in methanol poisoning patients [13][14][15][16]. Furthermore, there are even more limited published studies (Jaff et al [17] and Sanaei-zadeh et al [18]) about the electrocardiographic manifestations in patients with methanol poisoning; On the other hand, it has not been established yet whether or not the electrocardiographic ndings can predict mortality [18].…”

Single center experience of managing methanol poisoning in the hilly state of uttarakhand: A cross sectional study

“…study on 50 methanol patients showed acute kidney injury in 33 patients (66%) and concluded as a useful predictor of hospital mortality. [18] In a study by Verhelst et al ., acute renal injury was found in 15 of 25 (60%) patients. [19] Salek et al .…”

Subcutaneous Erythropoietin Reverses Optic Neuropathy Induced by Methanol Poisoning: Three Case Reports

“…Methanol is metabolized to formate (formic acid), which is responsible for visual impairment, blurred vision, impaired visual field and ultimately blindness. Other complications and adverse effects of methanol poisoning include: meta-bolic acidosis, coma, multi-organ failure and even death [2][3][4][5][6]. Because of high prevalence and mortality in Iran due to methanol intoxication, early diagnosis and effective treatment is of clinical significance [7].…”