Hepatorenal toxicity and mortality following acute paraquat poisoning in Hirakud Command Area, Odisha, India: a prospective observational study

Paraquat is a widely used herbicide known for its high toxicity and lack of an effective antidote. Accidental or intentional ingestion of paraquat leads to severe multi-organ damage, particularly affecting hepatic and renal systems. The present study aimed to assess the pattern of hepatorenal toxicity and associated mortality among patients with acute paraquat poisoning in the farming community of the Hirakud Command Area, Odisha. A hospital-based observational study was conducted on patients admitted with a confirmed history of acute paraquat ingestion. Clinical presentations, biochemical parameters including liver function tests (AST, ALT, bilirubin) and renal function indicators (serum creatinine, urea), along with patient outcomes, were recorded and analyzed. Data were statistically evaluated to determine the relationship between hepatorenal impairment and mortality. A total of 129 patients were included in the study, with a majority belonging to the active farming population. Elevated levels of hepatic enzymes such as ALP, AST and bilirubin and serum creatinine and urea were observed in most cases, indicating significant hepatic and renal dysfunction. With a strong association between the degree of hepatorenal impairment and fatal outcomes ( p < 0.05). Delay in hospital admission and higher estimated paraquat dose intake were key predictors of mortality. Acute paraquat poisoning continues to pose a serious health risk among farmers in the Hirakud Command Area. The study highlights the critical role of early diagnosis and aggressive supportive management in improving survival. Strengthening community awareness and restricting paraquat availability are essential to mitigate its public health impact.