Five cases of acute kidney injury caused by occupational acute dimethyl oxalate poisoning / 中国职业医学

ABSTRACT

OBJECTIVE: To investigate the clinical features and treatment methods of acute kidney injury induced by occupational acute dimethyl oxalate( DMO) poisoning.METHODS: Retrospective analysis was performed on the clinical data of 5 patients with acute kidney injury induced by occupational DMO poisoning.RESULTS: A large number of crystals of DMO were found in the workplace in field investigation.Five patients had acute onset.The main manifestations included dizziness,fatigue,nausea,vomiting,anorexia,lumbar and abdominal pain,skin burning sensation,oliguria,peeling changes on the skin of neck,the front chest and perineum,and low calcium,anemia,and pulmonary infection.The laboratory examinations suggested acute kidney injury,creatinine at the onset was 159-421 μmol/L.The highest creatinine level was up to 848μmol/L in the course.The renal pathology of a case suggested acute tubular injury with tubular deposition of oxalate crystals in the lumen.After blood purification( treated with hemodialysis mainly,combined with continuous hemofihration and hemoperfusion intermittently) combined with anti-oxidative stress,liver protection,nutritional support and other symptomatic treatment,renal function of the 4 cases with oliguria returned to normal.CONCLUSION: Occupational acute DMO poisoning mainly leads to kidney injury.The treatment is mainly based on hemodialysis and anti-oxidative stress.The prognosis of patients is good.