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KMID : 1013220200180020110
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Jouranl of the Korean Society of Clinical Toxicology
2020 Volume.18 No. 2 p.110 ~ p.115
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Clinical Characteristics and Risk Factors of Acute Kidney Injury in Patients with Glyphosate Poisoning
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Park Hyung-Hun
Choi Kyu-Ill
Lee Je-Won
Park Jung-Min
Park Jin-Wook
Noh Sang-Moon
Cho Jae-Kyung
Lee Dae-Ro
Cho Jae-Chul
Park Dong-Chan
Kim Yang-Hun
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Abstract
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Purpose: Acute kidney injury (AKI) in patients with glyphosate poisoning has a poor prognosis. This study aimed to predict the risk factors for AKI in patients with glyphosate poisoning at the emergency department (ED).
Methods: Clinical data on glyphosate poisoning patients at ED who were older than 18 years were collected retrospectively between January 2013 and December 2019. The clinical characteristics and clinical outcomes of the AKI group in patients with glyphosate poisoning were compared with the non-AKI (NAKI) group.
Results: Of 63 glyphosate poisoning patients, AKI was observed in 15 (23.8%). The AKI patients group showed the following: old age (p=0.038), low systolic blood pressure (p=0.021), large amount of ingestion (p=0.026), delayed hospital visits (p=0.009), high white blood cells (WBC) (p<0.001), high neutrophil counts (p<0.001), high neutrophil-lymphocyte (LN) ratios (p<0.001), high serum potassium (p=0.005), low arterial blood pH (p=0.015), and low pO2 (p=0.021), low bicarbonate (p=0.009), and high Poisoning Severity Score (PSS) (p<0.001). AKI patients required hemodialysis, ventilator care (p<0.001, p=0.002), and inotropics (p<0.001).
They also showed more intensive care unit admission (p<0.001), longer hospitalization (p<0.001), and high mortality (p<0.001).
Logistic multivariate regression analysis showed that high WBCs (OR, 1.223) and increased LN ratios (OR, 1.414) were independently associated with the occurrence of AKI.
Conclusion: In patients with glyphosate poisoning at ED, high WBCs and increased LN ratios can help predict the occurrence of AKI.
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KEYWORD
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Glyphosate, Herbicide, Poisoning, Acute kidney injury
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