Abstract：
Keratin-based hair-straightening treatment is a popular hair-styling method. The majority of keratin-based hair-straightening products in Israel contain glycolic acid derivatives, which are considered safe when used topically. Systemic absorption of these products is possible, and anecdotal reports have described kidney toxicity associated with their use. We report a series of cases of severe acute kidney injury (AKI) following use of hair-straightening treatment in Israel during the past several years.
Case series.
We retrospectively identified 26 patients from 14 medical centers in Israel who experienced severe AKI and reported prior treatment with hair-straightening products in 2019-2022.
The 26 patients described had a median age of 28.5 (range, 14-58) years and experienced severe AKI following a hair-straightening procedure. The most common symptoms at presentation were nausea, vomiting, and abdominal pain. Scalp rash was noted in 10 (38%) patients. Two patients experienced a recurrent episode of AKI following a repeat hair-straightening treatment. Seven patients underwent kidney biopsies, which demonstrated intratubular calcium oxalate deposition in 6 and microcalcification in tubular cells in 1. In all biopsies, signs of acute tubular injury were present, and an interstitial infiltrate was noted in 4 cases. Three patients required temporary dialysis.
Retrospective uncontrolled study, small number of kidney biopsies.
This series describes cases of AKI with prior exposure to hair-straightening treatments. Acute oxalate nephropathy was the dominant finding on kidney biopsies, which may be related to absorption of glycolic acid derivatives and their metabolism to oxalate. This case series suggests a potential underrecognized cause of AKI in the young healthy population. Further studies are needed to confirm this association and to assess the extent of this phenomenon as well as its pathogenesis.
Case series.
We retrospectively identified 26 patients from 14 medical centers in Israel who experienced severe AKI and reported prior treatment with hair-straightening products in 2019-2022.
The 26 patients described had a median age of 28.5 (range, 14-58) years and experienced severe AKI following a hair-straightening procedure. The most common symptoms at presentation were nausea, vomiting, and abdominal pain. Scalp rash was noted in 10 (38%) patients. Two patients experienced a recurrent episode of AKI following a repeat hair-straightening treatment. Seven patients underwent kidney biopsies, which demonstrated intratubular calcium oxalate deposition in 6 and microcalcification in tubular cells in 1. In all biopsies, signs of acute tubular injury were present, and an interstitial infiltrate was noted in 4 cases. Three patients required temporary dialysis.
Retrospective uncontrolled study, small number of kidney biopsies.
This series describes cases of AKI with prior exposure to hair-straightening treatments. Acute oxalate nephropathy was the dominant finding on kidney biopsies, which may be related to absorption of glycolic acid derivatives and their metabolism to oxalate. This case series suggests a potential underrecognized cause of AKI in the young healthy population. Further studies are needed to confirm this association and to assess the extent of this phenomenon as well as its pathogenesis.
摘要：
目的：基于角蛋白的头发拉直治疗是一种流行的头发造型方法。以色列的大多数产品含有乙醇酸衍生物，在局部使用时被认为是安全的。这些产品的全身吸收是可能的，并且轶事报道已经描述了与它们的使用相关的肾毒性。我们报告了过去几年在以色列使用直发治疗后发生的一系列严重AKI病例。
方法：案例系列。
方法：我们回顾性地确定了来自以色列14个医疗中心的26例患者，这些患者在2019年至2022年间发生了严重的AKI，并报告了之前使用直发产品进行的治疗。
结果：所描述的26例患者的中位年龄为28.5岁（范围，14-58），并在头发拉直程序后出现严重的AKI。最常见的症状是恶心，呕吐,和腹痛。10例（38%）患者出现皮疹。两名患者在重复头发拉直治疗后出现了AKI的复发发作。7例患者接受了肾脏活检，其中6例显示肾小管内草酸钙沉积，其中1例显示肾小管细胞微钙化。在所有活检中，出现急性肾小管损伤的迹象，4例出现间质浸润。三名患者需要临时透析。
结论：回顾性非对照研究，少量的肾脏活检。
结论：本研究描述了在接受头发拉直治疗之前的急性肾损伤病例。急性草酸盐肾病是肾脏活检的主要发现，这可能与乙醇酸衍生物的吸收及其向草酸盐的代谢有关。该病例系列提示了年轻健康人群中AKI的潜在原因。需要进一步的研究来证实这种关联，并评估这种现象的程度及其发病机理。
方法：案例系列。
方法：我们回顾性地确定了来自以色列14个医疗中心的26例患者，这些患者在2019年至2022年间发生了严重的AKI，并报告了之前使用直发产品进行的治疗。
结果：所描述的26例患者的中位年龄为28.5岁（范围，14-58），并在头发拉直程序后出现严重的AKI。最常见的症状是恶心，呕吐,和腹痛。10例（38%）患者出现皮疹。两名患者在重复头发拉直治疗后出现了AKI的复发发作。7例患者接受了肾脏活检，其中6例显示肾小管内草酸钙沉积，其中1例显示肾小管细胞微钙化。在所有活检中，出现急性肾小管损伤的迹象，4例出现间质浸润。三名患者需要临时透析。
结论：回顾性非对照研究，少量的肾脏活检。
结论：本研究描述了在接受头发拉直治疗之前的急性肾损伤病例。急性草酸盐肾病是肾脏活检的主要发现，这可能与乙醇酸衍生物的吸收及其向草酸盐的代谢有关。该病例系列提示了年轻健康人群中AKI的潜在原因。需要进一步的研究来证实这种关联，并评估这种现象的程度及其发病机理。
