Clinical Data on Acute Kidney Injury Caused by Acute Organophosphorus Pesticide Poisoning

摘要

Background: Organophosphorus pesticides (OPs) are widely used in China and some developed countries because they are powerful pesticides with minimal damage to crops. However, OPs are highly toxic, especially to the human lungs, heart, brain, kidneys. Research on the pathogenesis and risk factors of acute kidney injury (AKI) caused by OP poisoning is limited, Researches which tend to have small sample sizes and are commonly case reports. Objective: This study aims to investigate the pathogenesis and risk factors of AKI caused by acute organophosphorus poisoning syndrome (AOPP), in order to enable the adoption of early and reasonable treatment methods, to improve the prognosis of patients. Methods: Retrospective analysis was performed on the laboratory findings of 275 patients with acute OP poisoningl from January 2009 to June 2016. (1) The 275 patients with acute OP poisoning were grouped according to the presence or absence of AKI, and testing was performed for statistical differences in the relevant clinical indicators between the two groups. (2) Univariate analysis was performed to compare the differences in these indicators between the two groups, and indicators with statistically significant differences included in logistic regression and other methods to analyze the risk factors affecting AKI. Results: Among the 275 patients with acute OP poisoning, 92 (33.5%) had AKI. The cure rate of the AKI group was 69.6% and case fatality rate was 1.1% (1/92); the cure rate of the non-AKI group was 73.8% (135/183) and the case fatality rate was 0.5% (1/135); the difference in mortality rate between the two groups was not statistically significant (Z=0.94, P=0.34). Comparison of general information and clinical characteristics revealed that only the mean C-reactive protein (CRP) and SCr levels differed significantly between the two groups (Z=6.55, P0.001; t'=-3.14, P=0.002). Multivariate logistic regression analysis showed that the time of poisoning, time to blood purification therapy and CRP level were factors influencing the onset of AKI. The relationship between CRP level and logitP(AKI=1) was non-linear, and so no interpretation was made on the OR size. Conclusion: 1. The rate of AKI about acute OP poisoning is 54.4%, Both glomeruli and tubules were involved. 2. The prognosis of patients with AKI is relatively poor. 3. The risk factors influencing AKI caused acute OP poisoning may be related to prolonged time of poisoning, prolonged time to blood purification therapy and high CRP level.