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.
Curry RW, Robinson JD, Sughrue MJ. Acute Renal Failure After Acetaminophen Ingestion. JAMA. 1982;247(7):1012-1014. doi:10.1001/jama.1982.03320320048029