Acute Toxin Associated Kidney Injury With Renal Recovery

Paraquat(1, 1’-dimethyl-4,4’-bipyridium dichloride)is a commonly used contact herbicide in India. Chronic toxicities are not known since it inactivates on coming in contact with soil. The notoriety associated with paraquat is because it came to be used as a commonly used and cheap modality for intentional suicidal use. When ingested, paraquat is quickly but incompletely absorbed and the rest is largely excreted by the kidneys, unchanged, in about 12-24 hours from ingestion. But within the first few hours of ingestion paraquat is actively taken up against a marked concentration gradient into the type II pneumocyte from where the elimination is much slower. Due to its pharmacokinetics, the first two target organs are lungs and kidneys. Suicidal poisoning with paraquat has a very high fatality since there is no known antidote. We present a young lady who presented with a delayed presentation of intentional paraquat poisoning with good renal recovery. The patient however succumbed due to respiratory failure.