Research Paraquat Poisoning Clinical Indicators Of Acute Kidney Damage

Objective:Dynamic monitoring of changes in renal function in acute paraquat poisoning patients, the clinical features of acute kidney injury in patients with acute paraquat poisoning, provide the basis for early diagnosis and treatment.Methods:Forty three patients, of which21male and22female aged (37.72±14.96)were recruited,the inclusion criteria for the exclusion of patients with chronic kidney disease and other poisoning.the dose of poison at around20-200ml, hospitalized two weeks in order to survive as a standard, into the death of18cases,25patients survived.1,3,7,14poisoning in patients taking fasting blood5ml each day and morning urine specimens from the middle, The routine blood CysC, CREA,BUN et al were monitored.20healthy controls in out-patient clinic, including9males and11females,aged (45.00±10.08) were also recruited.Results:Early in patients with acute paraquat poisoning can cause varying degrees of renal injury. Compared with the healthy control group, the level of serum Cystatin (cystatin C) and NGAL in the survival group and death group were significantly increased, and had statistical significance (P<0.01). Compared with the serum creatinine (SCr), blood urea nitrogen (BUN), the level of serum Cys-C and NGAL in the survival group and death group were significantly increased. Compared with the survival group, the level of serum serum creatinine (SCr), blood urea nitrogen (BUN) Cystatin C and NGAL in the death group were significantly increased and had statistical significance (P<0.01). On the first day of intoxication serum CysC and NGAL was significantly higher (P<0.01). On the3th, serum BUN and CREA significantly higher. The level of serum cystatin (cystatin C), blood urea nitrogen (BUN) and NGAL were significantly and dynamic increased between poisoning group and controls, and had statistical significance. In ROC analysis, When creatinine area under the curve of0.758to90.7umol/L as the cut-off point, the sensitivity to predict mortality in patients with acute paraquat poisoning was66.7%, specificity97.8%; area under the curve of0.810Urea nitrogen to5.905mmol/L as when the cut-off point, the sensitivity to predict mortality in patients with acute paraquat poisoning was72.2%, specificity91.1%; area under the curve of0.778β2-MG, when2.065mg/L as the cut-off point to predict death in patients with acute paraquat poisoning the sensitivity was62.2%and specificity of83.3%; CysC area under the curve of0.848, when1.94umol/L as the cut-off point to predict mortality in patients with paraquat poisoning sensitivity66.7%, specificity95.6%; urinary NGAL area under the curve of0.831, urine NGAL to58.64ug/L cut-off point when predicting the sensitivity of paraquat poisoning death in patients was61.1%, specificity was95.6%. Conclusions:1、Paraquat poisoning early renal damage, suggesting that patients poor prognosis.2、CysC serum and urine NGAL acute paraquat poisoning acute kidney injury early sensitive indicator.