Reversible Nephropathy Associated with Jet Fuel Exposure

Latif A Salam,Khabbab Amin,Noriyuki Murakami,Clinton Brown,Lawrence Kwon,Regina Cheng

doi:10.1155/2020/2932415

Latif A Salam, Khabbab Amin + Show 4 more

Open Access

https://doi.org/10.1155/2020/2932415

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Abstract

Acute kidney injury (AKI) with progression to oliguric or anuric acute renal failure (ARF) is often related to use of well-known nephrotoxic agents including medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), angiotensin-converting enzyme inhibitors (ACEis)/angiotensin II receptor blockers (ARBs), and certain classes of antibiotics. Hyperosmolar IV contrast is also a well-known nephrotoxic agent. Severe sepsis with subsequent hypotension, marked hyperglycemia, and those with difficulty accessing water or with poor oral intake can also present with acute kidney injury related to kidney hypoperfusion, dehydration, and volume depletion. In this case report, we discover and discuss the possible effects of regular and daily occupational exposure of jet fuel (a mixture of hydrocarbons) on renal function. Jet fuel is an underdescribed and not well-known nephrotoxic agent; however, its direct toxicity on kidney function appears to be reversible with removal of exposure and aggressive fluid hydration.

Highlights

Jet fuel is a common exposure amongst those working in airports and military bases
Detoxification of organic solvents within the liver produces water-soluble compounds, which are excreted through urine or bile, making the kidneys a potential site of injury in the metabolism of hydrocarbons found in jet fuels [6]
It is very likely that our patient has underlying chronic kidney disease stage II or III and the blood urea nitrogen (BUN)/Cr values at discharge are his baseline renal function

Summary

Reversible Nephropathy Associated with Jet Fuel Exposure

Severe sepsis with subsequent hypotension, marked hyperglycemia, and those with difficulty accessing water or with poor oral intake can present with acute kidney injury related to kidney hypoperfusion, dehydration, and volume depletion. In this case report, we discover and discuss the possible effects of regular and daily occupational exposure of jet fuel (a mixture of hydrocarbons) on renal function. Jet fuel is an underdescribed and not well-known nephrotoxic agent; its direct toxicity on kidney function appears to be reversible with removal of exposure and aggressive fluid hydration

Introduction

Discussion

Findings

BUN Serum Cr