Outcomes of death and prolonged renal insufficiency in ethylene glycol poisoned patients

Int Urol Nephrol. 2022 Jan;54(1):149-155. doi: 10.1007/s11255-021-02837-3. Epub 2021 Mar 18.

Abstract

Background: Despite the severity of ethylene glycol intoxication, there is a paucity of studies that analyze prognostic factors. This study aims to determine prognostic factors with impact on core outcomes like death and prolonged kidney injury (KI) in ethylene glycol poisoned patients.

Methods: We retrospectively assessed prevalence, clinical and biochemical features in one large data set from two regional hospitals from the North-East region of Romania, between January 2012 and October 2017. Secondly, we compared prognostic factors of cases treated with dialysis plus antidote (N = 28 patients) with cases who received antidote only and supportive therapy (N = 28 patients).

Results: Of the 56 cases included, 16 deaths (28.57%) were recorded. The symptomatology at admission was more severe among patients requiring hemodialysis: a lower mean value for initial pH, lower initial alkaline reserve (AR) and higher mean values for initial serum creatinine (Cr1). The data analysis (survivors/deceased) showed a correlation between pH, Glasgow Coma Score (GCS), and increased mortality. In addition, we found a correlation between initial mean values for pH, AR (mmol/L), Cr1 (mg/dL), and peak Cr24 (mg/dL) with outcomes of RI or death.

Conclusions: Compared with survivors, patients who died or had prolonged kidney injury were more likely to exhibit clinical signs such as coma, seizures, and acidosis. Hemodialysis and antidote should be started early and continued until acidosis is corrected.

Keywords: Acute kidney injury; Dialysis; Ethylene glycol intoxication; Mortality.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ethylene Glycol / poisoning*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Renal Insufficiency / chemically induced*
  • Renal Insufficiency / diagnosis
  • Renal Insufficiency / epidemiology
  • Renal Insufficiency / mortality*
  • Retrospective Studies
  • Time Factors
  • Young Adult

Substances

  • Ethylene Glycol