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Nefrología (Madrid)
On-line version ISSN 1989-2284Print version ISSN 0211-6995
Abstract
FRANCESCO DAHER, Elizabeth De et al. Acute kidney injury due to excessive and prolonged intramuscular injection of veterinary supplements containing vitamins A, D and E: A series of 16 cases. Nefrología (Madr.) [online]. 2017, vol.37, n.1, pp.61-67. ISSN 1989-2284. https://dx.doi.org/10.1016/j.nefro.2016.05.017.
Background:
Despite well-documented risks, injectable supplements containing high doses of vitamins are commonly used.
Objectives:
To describe acute kidney injury (AKI) as a complication of vitamin intoxication.
Methods:
Our series consisted of 16 patients with kidney complications resulting from the use of veterinary intramuscular injection supplements of vitamin A, D and E. The patients were admitted to two referral hospitals in Fortaleza (Brazil) between January 2010 and January 2015.
Results:
Patients’ mean age was 28.3 ± 8.9 years (19-53 years), and 11 (68.7%) were male. Main signs and symptoms upon admission were nausea (68.7%), vomiting (62.5%), weight loss (43.7%), epigastric pain (31.2%) and headache (31.2%). At hospital admission the mean laboratory values were: hemoglobin 10 ± 2.0 g/dL (6.1-14.2), leukocytes 10,542 ± 4871/mm3 (4100-15,100), creatinine 3.9 ± 5.2 mg/dL (0.7-22) and urea 91 ± 88 mg/dL (22-306), respectively. Serum calcium was 12 ± 2.2 mg/dL (8.8-15.5), 24-h urine calcium was 575 ± 329 mg (10.7-1058), serum PTH was 55 ± 141 pg/mL (2-406), and serum vitamin D concentration was 135 ± 75 ng/mL (22-265). Using KDIGO criteria, AKI was diagnosed in 13 patients (81.2%), classified as stage 1 (n = 3), stage 2 (n = 3) or stage 3 (n = 7). No deaths occurred in the study period.
Conclusions:
Excessive use of veterinary vitamin supplements containing high doses of vitamin A, D and E was associated with AKI. Hypercalcaemia, which was a common finding, appears to be a contributing factor to the development of this type of AKI.
Keywords : Acute kidney injury; Vitamin supplements; Hypercalcaemia.