Ethylene Glycol Poisoning With Oxalate Nephropathy and Acute Kidney Injury: A Case Report and Review of the Literature

Ethylene glycol (EG) is a hazardous alcohol present in various household and industrial products. After being metabolized by ethanol dehydrogenase and aldehyde dehydrogenase, it can produce glycolate, acetaldehyde, and oxalate, leading to acute kidney injury. Renal failure is mainly caused by tubular damage induced by metabolites such as glyoxylate and oxalate, and may also be related to tubular obstruction caused by oxalate crystal precipitation. A 35-year-old Chinese man was brought to the emergency department in an unconscious state with a suspected history of EG ingestion. Laboratory examination revealed significant metabolic acidosis with elevated anion gap, acute kidney injury, and hyperkalemia, suggestive of possible EG poisoning. Renal biopsy revealed acute tubular necrosis, with numerous oxalate crystals forming in the tubules of the patient, confirming the diagnosis of EG poisoning with oxalate nephropathy. Treatment included fluid resuscitation, bicarbonate therapy, ethyl alcohol administration, and hemodialysis. After early and active treatment, the patient's consciousness recovered, acidosis improved significantly, and no further dialysis treatment was required.