Incidence of Acute Kidney Injury Among Cases with Suicidal Attempts of Paraphenylenediamine Poisoning in Aswan University Hospital

Abstract

Background: The rate of suicidal attempts with paraphenylenediamine (PPD) poisoning has raised steadily in the past few decades. Recently, a growing body of evidence demonstrated that PPD can lead to acute kidney injury (AKI). Objectives: To assess the incidence of AKI among cases with suicidal attempts of PPD poisoning in Aswan University hospital. Patients and Methods: Our study was a cross-sectional study that included 94 patients presented with suicidal attempts of paraphenylenediamine (dark hair dye) at Aswan University Hospital during the period from January to December 2019. All of the participants were subjected to history taking as age, sex, route of administration, suicidal or accidental intake of dye, type and amount of dye used, and duration of intake. Examination and investigations were as follows, vital data: BP, temperature, pulse, respiratory rate, electrocardiogram (ECG ), urine analysis, blood urea, serum creatinine, serum sodium, serum potassium, creatine phosphokinase (CPK), alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum uric acid, arterial blood gases (ABG) and follow up for the development of any complications or any interventions as tracheostomy, intubation, and hemodialysis. Results: The mean age of the included patients was 26.1 ±12.9 years and the majority of them were females (66%). In terms of the primary outcome of the present study, we found that the incidence of AKI was 29.7%. There were statistically significant differences between AKI and non-AKI patients in terms of serum ALT (p =0.001), serum AST (p =0.001), serum urea (p =0.001), serum creatinine (p =0.001), and serum CPK (p =0.001). Additionally, patients with AKI had a significantly higher mortality rate than non-AKI patients (p =0.023). Serum CPK was a major predictor of AKI in the univariate analysis. Conclusion: In conclusion, AKI is considered one of the most common problems in patients with suicidal attempts of PDD ingestion. AKI is one of the leading causes of mortality in patients with PPD ingestion.