I've recently mentioned other renal complications of acetaminophen ingestion: wide gap acidosis in therapeutic use and AKI with overdose. Now a paper in the American Journal of Emergency Medicine describes wide gap acidosis in overdose. It was seen in 41% of patients in their series, occurred early in the course, resolved in a day or so and did not predict outcome. These patients tended to have elevated lactate levels and the mechanism may differ from that of wide gap acidosis associated with therapeutic use.
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