RENAL-FAILURE IS UNCOMMON IN CHINESE PATIENTS WITH PARACETAMOL (ACETAMINAPHEN) POISONING

The reported incidence of renal failure in unselected patients with pa racetamol poisoning is about 1-2%. Since the introduction of antidotal therapy for paracetamol poisoning in 1973, renal failure is now mainl y seen in those admitted too late for effective therapy and is usually associated with liver damage. To determine the incidence of renal fai lure in Chinese patients with paracetamol poisoning, a retrospective s urvey was conducted of 224 patients admitted to the Prince of Wales Ho spital, Hong Kong, with paracetamol poisoning from January 1988 to Jan uary 1994. Of the 28 patients at risk (plasma paracetamol concentratio ns above the recommended treatment line), 13 developed liver damage wh ich was severe in 5. One patient with severe liver damage developed a transient increase in plasma creatinine concentration from 90 to 116 u mol/L. All 28 patients completely recovered. Renal failure was uncommo n in Chinese subjects (0.4%), and this was probably related to a lower incidence of liver damage which may be due to less chronic alcoholism as well as ethnic differences in paracetamol metabolism resulting in an inherent reduced susceptibility to its liver and renal toxicity.