Acute Tramadol Ingestion With Transient Acute Kidney Injury in an Adolescent Female.

Acute Tramadol Ingestion With Transient Acute Kidney Injury in an Adolescent Female.

Mike TB; DeVault H; Blackford MG

Journal Of Pediatric Pharmacology & Therapeutics

2021

2021-05-19

Renal toxicity has been described with tramadol overdoses; however, it is typically associated with rhabdomyolysis, multiorgan failure and/or mortality. Our patient was a 16-year-old female who was evaluated following an intentional tramadol ingestion, estimated 27.8 to 37 mg/kg, and had a seizure prior to arriving at our health care facility. Her symptoms were consistent with a tramadol ingestion; however, she developed transient acute renal impairment (peak serum creatinine, 4.04 mg/dL), which improved over 6 days with minimal intervention. No other causes were identified to explain her acute renal impairment thus it was attributed to the tramadol overdose. Providers should be aware that transient acute renal impairment could occur with an intentional tramadol ingestion and may not require aggressive intervention.

Tramadol is a centrally acting synthetic analgesic medication with both opioid and non-opioid affects, and it inhibits the re-uptake inhibitor of norepinephrine and serotonin. It is hepatically metabolized via CYP2D6 to its active metabolite, O-desmethyltramadol, which has greater pharmacologic activity than the parent compound. Both are excreted in the urine. Renal toxicity has been described with tramadol overdoses; however, it is typically associated with rhabdomyolysis, multiorgan failure, and/or mortality.1–3 We describe an adolescent who developed transient intrinsic renal injury, not associated with rhabdomyolysis, following an intentional overdose of tramadol.

Pediatric Pharmacy Association. All rights reserved.

Journal Article

411-413

4

26

NEOMED College of Medicine

Department of Pediatrics

Jan to Aug 2021 list