Nephrotoxicity biomarkers following propanil (3,4-dichloropropionanilide) self-poisoning.

Propanil is a toxic substance that can cause severe and prolonged methemoglobinemia, cyanosis, acidosis, and progressive end-organ dysfunction. Methaemoglobinaemia is a condition where the hemoglobin in the blood is oxidized, reducing the amount of oxygen delivered to the body's tissues. In addition to its effects on the blood, propanil has also been shown to be toxic to the kidneys in in-vitro studies, although this has not been extensively studied in humans. A recent study aimed to investigate the incidence of acute kidney injury and methemoglobinemia in patients who had self-poisoned with propanil. The study recruited 67 previously healthy patients who had self-poisoned with propanil between 2010 and 2014. The patient's

blood and urine samples were analyzed for various biomarkers, including kidney injury molecule-1, trefoil factor 3, neutrophil gelatinase-associated lipocalin, and beta2 microglobulin. The results showed that 40% of the patients developed acute kidney injury, with 32% developing stage 1 and 8% developing stage 2. The study found that serum creatinine concentrations had a very good diagnostic performance in detecting acute kidney injury, with area under the receiver operating characteristic curve values of 0.79-0.96. In contrast, the novel biomarkers tested had poor diagnostic performance, which may be attributed to non-renal factors influencing creatinine concentration or an unusual site or mechanism of nephrotoxicity after propanil poisoning. The study also found that blood methemoglobin levels were higher in patients with acute kidney injury and correlated with plasma propanil and 3,4-dichloroaniline concentrations. The results suggest that patients with propanil self-poisoning can develop reversible kidney injury, which can be diagnosed using serum creatinine concentrations within 4 hours of ingestion. Overall, the study highlights the importance of monitoring kidney function in patients with propanil poisoning and the need for further research into the mechanisms of propanil-induced kidney injury.

Link: https://pubmed.ncbi.nlm.nih.gov/40034038/