Aluminum citrate treatment decreases the renal toxicity associated with ethylene glycol poisoning in Wistar rats

Abstract

Ethylene glycol (EG) is responsible for ∼5000 poisonings a year. EG metabolites, especially calcium oxalate monohydrate (COM), produce the observed renal toxicity. Therapy from accumulated COM is needed for patients who are not diagnosed rapidly. Aluminum citrate (AC) decreases and reverses COM induced cytotoxicity in human proximal tubule (HPT) cells. The current study was designed to show that AC can decrease EG‐induced renal toxicity in vivo. Male Wistar rats were treated with EG (2 g/kg) or an equal volume of water by oral gavage. At 6 h post EG treatment, animals received either 1 mmol/kg AC by oral gavage or 0.1 mmol/kg AC by IV infusion. Urine was collected for 24 h, at which time, the right kidney was perfused with ethidium homodimer, the animal was sacrificed and the kidneys were harvested for analysis. Urine oxalate was decreased in rats treated with EG and AC compared to EG. N‐acetyl‐β‐D‐glucosaminidase (NAG) and γ‐glutamyltransferase (GGT) were measured as markers of nephrotoxicity. While GGT appeared unchanged, NAG appeared to be decreased in AC treated rats. H and E staining indicated the presence of COM crystals in all EG treated animals, but ethidium homodimer histology suggested a decrease in kidney cell necrosis of AC‐treated rats compared to EG controls. The results of this study indicate that AC may be a useful in treating the renal toxicity associated with EG poisoning.