Long-term clinical outcome for patients poisoned by the fungal nephrotoxin orellanine

BMC Nephrology

Research Article

Börje Haraldsson¹  Heidi Hedman¹  Johan Holmdahl²  Johan Mölne³  Jenny Nyström⁴  Kerstin Ebefors⁴ 

[1] Department of Molecular and Clinical Medicine, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Nephrology, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Pathology, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Physiology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, PO Box 432, SE-40530, Gothenburg, Sweden;

关键词: Case Control;    Acute Kidney Injury;    Chronic Kidney Disease Stage;    Polycystic Kidney Disease;    Kidney Graft;   

DOI  :  10.1186/s12882-017-0533-6

 received in 2016-04-01, accepted in 2017-03-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAccidental intake of mushrooms of the Cortinarius species (deadly webcap) may cause irreversible renal damage and the need for dialysis or transplantation. The species is found in forests of Northern Europe, Scandinavia and North America and may be mistaken for other edible mushrooms. The highly selective nephrotoxic compound of the mushroom is called orellanine. Very little is known about the long-term effects of the nephrotoxin.MethodsWe identified patients who ingested deadly webcap in the period of 1979 to 2012. Informed consent and medical records were obtained for 28 of the 39 cases that occurred during the 34-year period. A case control group was also studied based on sex, age and initiation of dialysis or transplantation.ResultsThe average age at time of the accidental intake was 40 ± 3 (n = 28) years. 64% of patients were male, and 22 of 28 patients developed acute kidney injury requiring dialysis. Serum creatinine peaked at 1 329 ± 133 μmol/l, and serum urea was 31 ± 3.5 mmol/l. No signs of acute damage were present in any other organ. The average time of follow-up was 16.9 ± 2.1 years (1.24–34.3 years, n = 28). 15 patients were transplanted and 3 also had a second graft. At follow-up, 23 patients were alive, and five had died at ages of 67 ± 5 (range 54–84). The outcome was similar in the case control group with 6 deaths in 20 patients.ConclusionWe conclude that the long-term prognosis for patients poisoned by deadly webcap who lost their renal function is not different compared to other patients in active uremic care.

【 授权许可】

CC BY   
© The Author(s). 2017