Creatinine Increase in a Young Girl Due to Tramadol Poisoning

Tramadol is an opioid with two differential mechanisms, including binding to the mu-opioid receptor and acting as a serotonin-norepinephrine reuptake inhibitor. Tramadol side effects are seizure and rhabdomyolysis. In this regard, the present report introduced a girl suffering from acute kidney injury and creatinine increase as a result of tramadol poisoning. Case Report: A girl was admitted to an intensive care unit with a diagnosis of tramadol overdose. Her symptoms included loss of conciseness and respiratory depression. She was intubated. Her urine toxicology test was positive for tramadol, and urea and creatinine levels were reported as 126 and 9.5 mg/dl, respectively. She underwent daily dialysis for 2 h; however, no decrease was observed in urea and creatinine levels. Daily dialysis increased to 3.5 h, and after 11 days, her creatinine and urea levels decreased to 3 and 20 mg/dl, respectively. The patient did not have any history of neurological diseases, and her brain computed tomography scan showed leukodystrophy. On the 12th day of hospitalization, the patient was separated from the ventilator and transferred to the ward. She was discharged after a week and recommended to continued psychiatric treatments.

Tramadol belongs to opioids and is usually sold without prescription. Seizure, rhabdomyolysis, kidney failure, and brain complications due to long hypoxia are the reported side effects, which are increasing in recent years. Therefore, higher control of tramadol legal and illegal distribution is required.