Acute Renal Failure After Acetaminophen Ingestion

Acute renal failure in the absence of severe hepatocellular damage developed in a young woman after ingestion of approximately 30 g of acetaminophen during a 36-hour period. Animal studies suggest that the nephrotoxic effect is due to a toxic oxidative metabolite of acetaminophen that arylates renal macromolecules. This case illustrates the need for detailed drug histories regarding over-the-counter medications. Acetaminophen ingestion should be considered in the differential diagnosis of acute renal failure. (JAMA1982;247:1012-1014)