Article Text

Download PDFPDF
Acute kidney injury after treatment of paracetamol overdose using new N-acetylcysteine guideline
  1. Eugen-Matthias Strehle1,2,
  2. Ivonne Haar1
  1. 1Paediatrics, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
  2. 2Medical School, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Eugen-Matthias Strehle, Paediatrics, Northumbria Healthcare NHS Foundation Trust, North Shields, NE29 8NH, UK; strehle{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

For several decades, UK children and young people (CYP) have been treated with the standard N-acetylcysteine (NAC) protocol following a paracetamol overdose (POD).1 Some patients develop liver impairment, but acute kidney injury (AKI) is uncommon.2 In 2021, the Scottish Newcastle Acetylcysteine Protocol (SNAP) was introduced in our trust, and since then, we have seen three cases of AKI after POD, which is unusual.3 This regimen has not been studied specifically in children and has not been approved by the Medicines and Healthcare products Regulatory Authority.

CYP 1 took a staggered POD of 10 and 5 g 10 hours apart and presented to the paediatric emergency department. Her blood paracetamol level was raised, and she was commenced on NAC according to the SNAP guideline (three bags). Next day, she was assessed by …

View Full Text


  • Collaborators Not applicable.

  • Contributors EMS formed the idea. EMS and IH contributed clinical cases and co-wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.