Renal and Metabolic Toxicity

Solvent abuse and occupational exposure to hydrocarbons may result in renal dysfunction. Exposure to hepatotoxic halogenated hydrocarbons, such as carbon tetrachloride and trichloroethylene, has caused acute renal failure as well as centrilobular hepatic necrosis. 15 Occupational hydrocarbon exposures have been associated with a variety of glomerulonephritides including Goodpasture's syndrome. —I8

Renal tubular acidosis may occur in patients who abuse toluene-containing substances. 1 Patients present with a non-anion gap metabolic acidosis, hypokalemia, and hypophosphatemia. The serum potassium may be so low (<2 meq/L) that severe muscle weakness develops, occasionally resulting in quadriparesis. Significant rhabdomyolysis may also result. Toluene toxicity may also cause a high anion gap metabolic acidosis as a result of the accumulation of hippuric acid and benzoic acid metabolites. Proteinuria and renal insufficiency can occur in patients who abuse toluene.

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