Accuracy of vital signs in early assessment of acute nephrotoxicity in acutely poisoned patients

Mohamed, Mohamed Hamdi; Shokry, Meray Medhat; Abdallah, Essam; Hilal, Maha Abd-Elhamed; Mohamed, Emad Ahmed

doi:10.21608/smj.2024.335570.1510

Accuracy of vital signs in early assessment of acute nephrotoxicity in acutely poisoned patients

Document Type : Original Article

Authors

¹ Forensic and Clinical Toxicology Department, Faculty of medicine, Sohag Univerisity

² Sohag University

³ Forensic medicine, sohag university

⁴ Department of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Sohag, University

⁵ Internal Medicine Department, Faculty of Medicine, Sohag University, Sohag, Egypt

10.21608/smj.2024.335570.1510

Abstract

Introduction: Poisoning represents a public health problem. AKI and chronic kidney disease are known complications that can occur after acute poisoning with nephrotoxic drugs or poisons. Aim Of the Work: Evaluation of the accuracy of vital signs as predictors of acute kidney injury (AKI) and outcome of acutely poisoned patients.

Methods: This prospective study was carried out on 100 acutely intoxicated patients by nephrotoxic drugs and poisons. Results: 72% of the patients were men and 36% of the patients were between the ages of 18 and 30. AKI affected 21% of patients. Regarding the outcome, 43% of patients died or were discharged with issues requiring prolonged follow-up, whereas 57% of patients had recovered fully by the time they were discharged. Vital signs showed a non-significant difference between AKI groups and non-AKI patients’ group. Systolic and diastolic blood pressure significantly differ between completely recovered and dead or complicated recovered patients. The Receiver Operating Characteristic Curve found that the systolic blood pressure below 95 mm/Hg had an accuracy rate of 65.2% with acceptable discrimination for mortality and morbidity, sensitivity of 55.8%, and specificity of 80.7%. Diastolic blood pressure below 55 mm/Hg had an accuracy rate of 64.6% with acceptable discrimination for mortality and morbidity, sensitivity of 46.5%, and specificity of 84.2%. Conclusion: The study concluded vital signs can’t be used as predictors for the incidence of AKI but systolic and diastolic blood pressure are accepted prognostic markers for the morbidity and mortality in acutely intoxicated cases with nephrotoxic drugs or poisons.

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