Why Ethylene Glycol Causes Acute Kidney Failure

Why Ethylene Glycol Causes Acute Kidney Failure

Bumisuka.com – Why Ethylene Glycol Causes Acute Kidney Failure. Recently, the World Health Organization (WHO) described cases of acute kidney failure that occurred in children in The Gambia. As a result, as many as 66 children were reported to have died. The case of acute kidney failure is suspected to be related to cough medicine contaminated with harmful substances.

Several brands of cough medicine studied were contaminated with diethylene glycol and ethylene glycol in The Gambia. So, how does ethylene glycol cause acute kidney failure? Here’s the explanation!

1. Contaminated cough syrup in Gambia

WHO gave a warning regarding the finding of contaminated cough syrup on October 5, 2022. There were four cough medicine products analyzed, namely:

  • Promethazine Oral Solution
  • Kofexmalin Baby Cough Syrup
  • Makoff Baby Cough Syrup
  • Magrip N Cold Syrup

The four products are manufactured by Maiden Pharmaceuticals Limited, Haryana, India.

Based on the analysis of the samples of the four products, it was found that there was contamination of diethylene glycol and ethylene glycol. WHO explained that for the time being the product was only found in The Gambia. Meanwhile, the Indonesian Food and Drug Supervisory Agency (BPOM) stated that the four products and other products from the same manufacturer do not exist in Indonesia.

2. Dangers of ethylene glycol

Both diethylene glycol and ethylene glycol are toxic when consumed by humans and can be fatal. The various effects include:

  • Stomach pain.
  • Vomit.
  • Diarrhea.
  • Cannot urinate.
  • Changes in mental state.
  • Acute kidney failure which can lead to death.
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The Agency for Toxic Substances and Disease Registry (ATSDR) explains that ethylene glycol poisoning is mainly caused by the accumulation of harmful metabolites in the body. If not detected and treated immediately, ethylene glycol poisoning can cause serious effects that can be fatal.

3. The metabolism of ethylene glycol produces a variety of more toxic compounds

According to the ATSDR, most of ethylene glycol is metabolized in the liver and a small part in an unchanged form is excreted by the kidneys. The result of metabolism of ethylene glycol in the liver produces a variety of compounds that are more toxic.

The main products of ethylene glycol metabolism are:

  • Glycoaldehyde.
  • Glycolic acid.
  • Glyoxylic acid.
  • Oxalic acid.

4. Ethylene glycol can affect various organs of the body

Ethylene glycol and its metabolites initially affect the central nervous system, then the heart-lung system, and eventually lead to kidney failure. There are three stages of the occurrence of toxic effects, namely:

  • Central nervous system suppression phase: Unmetabolized ethylene glycol can depress the central nervous system.
  • Cardiopulmonary toxicity phase: Accumulation of ethylene glycol metabolites, especially glycolic acid, causes acid buildup in the blood or metabolic acidosis. In addition, the presence of calcium oxalate crystals that settle in the membranes of the brain, blood vessel walls, lungs, and myocardium cause injury to these tissues.
  • Renal toxicity phase: Acute renal failure occurs.

5. Why can ethylene glycol cause acute kidney failure?

The liver metabolizes ethylene glycol to oxalic acid. Medcape explains that calcium oxalate crystals can build up in the brain, kidneys, and heart.

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The presence of calcium oxalate metabolites that settle in the kidneys can reduce the ability of the kidneys to filter or filter the blood, causing acute kidney failure. Damage to the kidneys may occur 24 to 72 hours after exposure.

Most of the ethylene glycol is metabolized in the liver to produce a variety of more toxic compounds. Ethylene glycol can affect various organs of the body, such as the brain, heart, lungs, and kidneys. The presence of calcium oxalate metabolites that settle in the kidneys can reduce the ability of the kidneys to filter or filter the blood, causing acute kidney failure.

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