Association of Organophosphate Poisoning with Kidney Injury: A Mini Review

Abstract

Poisoning by Organophosphates is a public health problem particularly in developing countries. Although they are commonly used in agriculture as pesticides, unfortunately, their use as weapons in chemical warfare is not rare. Due to lack of control, they are usually available in stores. Individuals may be effected by these compounds either by accidents or suicidal attempts. Poisoning may ocur following peroral, inhalational or dermal intake. Due to structure of the compound (highly soluble), exposure by each route causes high morbidity and mortality. Organophosphates inhibit both acetylcholinesterase (AChE) and pseudocholinesterase. Inhibition of AChE results in accumulation of acetylcholine. This mechanism is the main reason for toxic effects. Toxic effects may present as muscarinic, nicotinic and central nervous system (CNS). Progression of the poisoning may be seen in three stages: cholinergic phase, intermediate syndrome and delayed neuropathy. Although cardiovascular, gastrointestinal, respiratory, ocular, musculoskeletal and CNS manfestations of the poisoning are well-described in the literature, its effects on renal system remains as a neglected field due to its scarcity. In this mini-review, our aim was to determine hazardous effects of OP poisoning on renal system and emphasize the importance of monitorization and early intervention.

Frequency of Acute Kidney Injury (AKI) among patients presenting with Organophosphate Poisoning at National Poison Control Centre, Karachi: A prospective cross-sectional survey

“…3,4 It also causes dysfunction of kidneys and may result in alarmingly raised serum creatinine levels indicating, Acute Kidney Injury (AKI) which is among the most frequent systematic complication following organophosphate poisoning. 4,5 Hence, intoxicated patients should receive immediate support, adequate hydration and immediate correction of acid-base balance to reduce the risk of AKI following organophosphate poisoning. 5,6 Pakistan is among the countries bearing considerable burden of organophosphate poisoning due to poor control over unregulated access and insufficient training and knowledge to handle pesticides in occupational settings.…”

“…4,5 Hence, intoxicated patients should receive immediate support, adequate hydration and immediate correction of acid-base balance to reduce the risk of AKI following organophosphate poisoning. 5,6 Pakistan is among the countries bearing considerable burden of organophosphate poisoning due to poor control over unregulated access and insufficient training and knowledge to handle pesticides in occupational settings. [7][8][9] Organophosphates poisoning is among the most prevalent forms of intentional and unintentional poisoning resulting in morbidity and mortality.…”

“… 3 , 4 It also causes dysfunction of kidneys and may result in alarmingly raised serum creatinine levels indicating, Acute Kidney Injury (AKI) which is among the most frequent systematic complication following organophosphate poisoning. 4 , 5 Hence, intoxicated patients should receive immediate support, adequate hydration and immediate correction of acid-base balance to reduce the risk of AKI following organophosphate poisoning. 5 , 6…”

“… 4 , 5 Hence, intoxicated patients should receive immediate support, adequate hydration and immediate correction of acid-base balance to reduce the risk of AKI following organophosphate poisoning. 5 , 6…”