The renal circulation in acute arsine poisoning
Authors: Pedersen, F; Ladefoged, J; Winkler, K; Baunoe, B; Munck, O
HERO ID: 1370773
HAPAB Seven examinations were performed in two patients who developed severe hemolysis and nephropathy . . .
HAPAB Seven examinations were performed in two patients who developed severe hemolysis and nephropathy following acute arsine poisoning. One patient ( No. 5 ) developed acute oliguric renal failure while in the other patient ( No. 6 ), the renal function was only moderately reduced. The renal blood flow was examined with the Xenon-133 wash-out technique and with a dye dilution method. Renal circulation times for chromium-51-labeled red cells and for iodine-131-labeled albumin were measured by an external counting method. In patient No. 5, renal function had almost ceased 1 and 10 days after intoxication; at these times the endogenous creatinine clearance was 0.02 and 0.04 ml/min, respectively and the renal blood flow was reduced to 142 and 133 ml/ min, respectively. On both the first and tenth day after poisoning, the cortical vascular volume was severly reduced and there was a slow blood flow through the kidney. On the 48th day after admission, the patient was in the phase of polyuria. The creatinine clearance was 9.6 ml/min and the blood flow through the kidney was unchanged from the first examination. The vascular volume continued to be low. Diuresis was normal and the creatinine clearance 54 ml/min 285 days after admission. At this time vascular volume in the cortex had risen to 24 ml/100 g, the vascular resistance was 30 min Hg/m/g/min and the blood flow through the kidney was 752 ml/min. On the first day of illness, the arsenic concentration in thyblood was 0.7 mcg/ml. In patient No. 6, the 24-hr creatinine clearance was 60 and 76 ml/min on the first and tenth day after poisoning, respectively. The mean blood flow was reduced in both examinations and varied from 1.4 to 1.9 ml/g/min. The vascular volume constituted about 20 ml/100 g cortex. Arsenic content in the blood was 1.14 mcg/ml on the ninth day of hospitalization. It was concluded that the reduction in kidney function was correlated to the degree of intravascular hemolysis and was not correlated to the concentration of arsine in the blood. EPIDEMIOLOGY AND TREATMENT $BULLETIN 69/12/00, 446