sodium-hypochlorite and Acute-Kidney-Injury

Sodium hypochlorite (bleach) is commonly used as an irrigant during dental procedures as well as a topical antiseptic agent. Although it is generally safe when applied topically, reports of accidental injection of sodium hypochlorite into tissue have been reported. Local necrosis, pain and nerve damage have been described as a result of exposure, but sodium hypo-chlorite has never been implicated as a cause of an acute kidney injury (AKI). In this report, we describe the first case of accidental sodium hypochlorite injection into the infraorbital tissue during a dental procedure that precipitated the AKI. We speculate that oxidative species induced by sodium hypochlorite caused AKI secondary to the renal tubular injury, causing mild acute tubular necrosis.

Topics: Acute Kidney Injury; Dental Caries; Ecchymosis; Edema; Humans; Iatrogenic Disease; Injections; Kidney Tubules; Medication Errors; Oxidants; Sodium Hypochlorite

Sodium hypochlorite is the active ingredient in bleach, a ubiquitous household disinfectant, and has known toxicities depending on route of exposure and amount. Acute kidney injury due to sodium hypochlorite exposure has never been reported. Patients that did develop nephrotoxicity following bleach exposure did so due to development of other risk factors for kidney injury such as volume depletion or sepsis.. We report a patient who presented with black urine after parenteral self-administration of a large quantity of bleach. We review the clinical presentation, laboratory and biopsy findings, and outcome as well as discuss possible mechanisms of sodium hypochlorite toxicity and management strategies.

Topics: Acute Kidney Injury; Adolescent; Bleaching Agents; Female; Humans; Injections, Intravenous; Kidney; Recovery of Function; Renal Dialysis; Renal Insufficiency; Sodium Hypochlorite; Suicide, Attempted; Treatment Outcome