Pesticide Toxic Nephropathy

Introduction to pesticide-induced nephropathy Nephropathyduetopesticideintoxication (nephropathyduetopesticideintoxication) refers to kidney damage caused by respiratory tract, skin absorption or misuse, self-administered pesticides during the production of pesticides. Kidney damage is mainly caused by renal tubule degeneration. A few severe cases can reach acute kidney. Functional failure. Proteinuria occurs clinically. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: multiple system organ failure

Etiology of pesticide-induced nephropathy

Cause:

Poisoning and kidney damage can result from prolonged or improper use and exposure to various pesticides.

Pathogenesis

It is still unclear, and may cause a large accumulation of acetylcholine in the body after poisoning, causing respiratory, circulatory disorders, systemic dehydration, shock and renal vasospasm to cause renal ischemia, hypoxia and poisons or their metabolites are directly excreted by the kidneys and directly damage the kidneys.

Pesticide toxic nephropathy prevention

Actively prevent the occurrence of diseases. Strictly control the dosage and method, and pay attention to personal protection. Pay attention to self-feeling during medication. If there is any discomfort, you should leave the scene in time, handle the poison and closely monitor the urine routine, urine enzymes, renal function changes, to prevent kidney disease. Toxic damage.

Pay attention to check urine, blood, reasonable use of drugs, treat diseases to protect liver and kidney, and promote the functional recovery of the body.

In the process of using hormones or cytotoxic drugs, it is necessary to prevent various toxic and side effects, and the corresponding drugs can be appropriately incorporated into the syndrome medicine to prevent and treat them. Such as Qingrejiedu or Qingli Damp-heat Chinese medicine can reduce the iatrogenic Cushing's side reaction caused by hormones; and stomach and spleen Chinese medicine can reduce the stimulation of hormones and other gastrointestinal tracts; Yishen filling Chinese medicine can prevent immunosuppressive agents against bone marrow And the excessive inhibition of the body's normal immunity.

Pesticide toxic nephropathy complications Complications, multiple system organ failure

Mainly complicated by systemic multi-system failure.

Multiple organ failure (MOF) is a clinical syndrome with a wide range of causes, complicated pathogenesis, and high mortality. MOF refers to a syndrome in which two or more organ dysfunctions, even functional failure, occur after the body has suffered severe damage (such as serious illness, trauma, surgery, infection, shock, etc.). MODS is an acute systemic organ dysfunction that is closely related to stress.

Pesticide toxic nephropathy symptoms Common symptoms Fatigue sensation protein urine hematuria abdominal pain convulsions dizziness edema tremor organophosphate poisoning

Kidney performance is generally not heavy, mainly proteinuria and microscopic hematuria, may have mild renal insufficiency, extra-renal performance is more obvious, mainly dizziness, dizziness, fatigue, sweating, abdominal pain, tremor, severe appearance Body convulsions, incontinence, pulmonary edema, visible dilated pupils, a large amount of white foam-like secretions in the mouth and nostrils, and smell of garlic-like odor.

Inspection of pesticide-induced nephropathy

Urine check

Visible proteinuria and microscopic hematuria, occasionally tubular urine.

2. Determination of blood cholinesterase (CHE) activity

It can be found that the activity of CHE is reduced, and the degree of poisoning and prognosis can be judged according to the level of CHE activity.

3. Identification of organophosphorus pesticides

The patient's vomit, secretions and urinary organophosphorus pesticide decomposition products can be measured to find the toxic species, renal pathology is mainly caused by renal tubular damage, renal tubular cell degeneration, swelling and necrosis can be seen.

Diagnosis and identification of pesticide-induced nephropathy

diagnosis

The diagnosis of this disease is not difficult, the patient has a history of exposure to pesticides, the typical clinical manifestations of organophosphate poisoning, the CHE activity in the blood is significantly reduced, and the secretions are found to be diagnosed with the poison.

Differential diagnosis

1. Identification with opioid poisoning

Opioid drugs are commonly found in opioids, morphine, codeine, compound camphorquinone, papaverine, meperidine, methadone, ethylmorphine, and drug acetaminophen, which have analgesic, antitussive, and antidiarrheal effects. Antispasmodic, anesthetic and other effects, clinical application is wide, but long-term use will produce dependence, one-time overuse or frequent application can cause poisoning.

Patients with mild acute poisoning present with dizziness, headache, nausea, vomiting, excitement or depression, or hallucinations, loss of time and space, constipation, urinary retention and elevated blood sugar, coma in severe poisoning, needle-like pupils, Three characteristics of high respiratory depression, such as vomiting, irritability, convulsions, flushing, tachycardia; but soon into the inhibition period, pale, cyanosis, feeling dull, muscle weakness, slow breathing , lethargic, pupils are significantly reduced; and then coma, spinal cord reflexes, often convulsions, closed jaws, angular reflexes, breathing first shallow, slow, followed by sigh-like breathing or tidal breathing, pulmonary edema, cyanosis, The limbs are cold, the body temperature drops, various reflexes disappear, and the pyramidal tract sign is positive; finally, respiratory failure is dead.

2. Identification of acute tubular necrosis caused by biotoxin

The main biotoxins that cause acute tubular necrosis are: raw fish bile, poisonous mites, snake venom, scorpion venom, etc. The main clinical manifestations are similar to pesticide poisoning, often causing nerve and other multi-system changes, severe cases lead to acute kidney Small tube necrosis should be distinguished from the disease.

3. Identification with cerebrovascular accidents

More hypertension, history of arteriosclerosis, signs of the nervous system, head CT examination can help diagnose.

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