Suicide attempt acute renal failure

Pesce et al. 1977). The authors of the report surmised that the increased excretion of both albumin and 2-microglobulin were indicative of mercury-induced tubular and glomerular pathology. Acute renal failure that persisted for 10 days was also observed in a 19-month-old child who ingested an unknown amount of powdered mercuric chloride (Samuels et al. 1982). Decreased urine was also observed in a 22-year-old who attempted suicide by ingesting approximately 20 mg Hg/kg (Chugh et al. 1978). 

At less than 2% in the clinical investigations acute renal failure, atrial fibrillation, cerebrovascular accident, sepsis, meningitis, psychotic disorder, suicidal ideation, respiratory distress, rhabdomyolysis, electrocardiogram abnormal, stupor, loss of consciousness, incoherent, clonic convulsion and grand mal convulsion. Rare instances of fatal pneumonia aspiration and suicide attempt were reported (<1%). 

Five patients with metformin-associated severe lactic acidosis, seen between 1 September 1998 and 31 May 2001, have been reported (58). Two had attempted suicide. All had severe metabolic acidosis with a high anion gap and raised blood lactate concentrations. Four developed profound hypotension and three had acute respiratory failure. Three had normal preceding renal function. Three required conventional hemodialysis and two continuous renal replacement therapy. 

Renal Effects. No studies were located regarding renal effects of various forms of aluminum following intermediate- or chronic-duration exposure in humans. Acute-duration oral exposure to aluminum phosphide has been shown to cause renal failure, significant proteinuria, and anuria in persons who ingested it either accidentally or in suicide attempts (Chopra et al. 1986 Khosla et al. 1988). However, toxicity was probably due to the formation of highly toxic phosphine gas rather than to aluminum exposure. 

A 36-year-old long-distance truck driver took 200 ml of ethylene glycol in a suicide attempt (32). He vomited, lost consciousness, and had miosis and external ophthalmoplegia. There was a severe metabolic acidosis with a wide anion gap and many crystals in the urinary sediment. Acute oliguric renal failure required continuous hemodialysis for 6 days. A CT scan of the brain showed low-density areas in the bilateral basal ganglia, midbrain, and pons. A renal biopsy showed tubular oxalate deposits. He gradually recovered within 36 days. 

This dye, paraphenylenediamine, when mixed with henna, blackens the hair in a very short time. The substance is a common cause of ATN in the Sudan [30]. It is also toxic to the heart and hver. It is absorbed through the skin but individuals have ingested the dye in suicide attempts. Within 3-4 hours after ingestion they develop angioneurotic oedema soon followed by renal failure. Renal biopsy shows the typical features of acute tubular necrosis. See chapter 40. 

Death. Cases of death in humans acutely exposed to airborne formaldehyde were not located. Death after the ingestion of fonnaldehyde (or a formalin solution) in humans has been reported in connection with attempted suicides. Metabolic acidosis has been noted prior to death, along with respiratory, cardiac, and renal failure autopsy revealed corrosive damage to gastrointestinal mucosa (Burkhart et al. 1990 Eells et al. 1981 Koppel et al. 1990). Increased rates of cancer-related mortality associated with occupational exposure to formaldehyde (predominately by inhalation) have been found in some epidemiological studies, but not in others (see Section 2.2.1.8 and Section 2.5). Animal studies indicate that subchronic inhalation exposure to concentrations below 20 ppm are not lethal (Feron et al. 1988 Maronpot et al. 1986 Martin 1990 Rusch et al. 1983 Saillenfait et al. 1989 Woutersen et al. 1987), but lifetime inhalation exposure to formaldehyde has been associated with early mortalities associated with... 

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