Acetylcysteine effect on kidney in acetaminophen toxicity

Q: Acetylcysteine given during acetaminophen toxicity to protect the liver - also has a protective effect on the kidney?

A) True

B) False

Answer: B

About half of patients with acetaminophen-induced liver failure may also develop some degree of acute kidney injury (AKI). Patient may develop proteinuria and/or hematuria. This injury occurs via two mechanisms - direct effect with acute tubular necrosis and ischemia due to vascular endothelial damage.

AKI is usually reversible. Unfortunately, despite a robust protective effect on the liver, acetylcysteine has no renal protective effect.

#nephrology

#hepatology

References:

1. Mazer M, Perrone J. Acetaminophen-induced nephrotoxicity: pathophysiology, clinical manifestations, and management. J Med Toxicol 2008; 4:2.

2. Blakely P, McDonald BR. Acute renal failure due to acetaminophen ingestion: a case report and review of the literature. J Am Soc Nephrol 1995; 6:48.