Pediatric Nephrology

, Volume 21, Issue 11, pp 1760–1764 | Cite as

Acute renal failure due to phenazopyridine (Pyridium®) overdose: case report and review of the literature

  • Ali Mirza OnderEmail author
  • Veronica Espinoza
  • Mariana E. Berho
  • Jayanthi Chandar
  • Gaston Zilleruelo
  • Carolyn Abitbol
Brief Report


Phenazopyridine (Pyridium®) is a commonly used urinary tract analgesic. It has been associated with yellow skin discoloration, hemolytic anemia, methemoglobinemia, and acute renal failure, especially in patients with preexisting kidney disease. We report a 17-year-old female with vertically transmitted human immunodeficiency virus (HIV) infection, presenting with acute renal failure and methemoglobinemia following a suicidal attempt with a single 1,200 mg ingestion of Pyridium®. She had no prior evidence of HIV nephropathy. The patient had a progressive nonoliguric renal failure on the 3rd day following the ingestion. She was treated with N-acetylcysteine, intravenous carnitine, and alkalinization of the urine. Her kidney biopsy revealed acute tubular necrosis with no glomerular changes. After 7 days of conservative management, she was discharged home with normal kidney function. To our knowledge, this is the second smallest amount of Pyridium® overdose resulting in acute renal failure with no previous history of kidney disease.


Pyridium® intoxication Acute renal failure Methemoglobinemia 


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Copyright information

© IPNA 2006

Authors and Affiliations

  • Ali Mirza Onder
    • 1
    Email author
  • Veronica Espinoza
    • 2
  • Mariana E. Berho
    • 3
  • Jayanthi Chandar
    • 1
  • Gaston Zilleruelo
    • 1
  • Carolyn Abitbol
    • 1
  1. 1.Department of Pediatrics, Division of Pediatric NephrologyUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Department of Pediatrics, Division of Pediatric Immunology and Infectious DiseasesUniversity of Miami Miller School of MedicineMiamiUSA
  3. 3.Department of PathologyUniversity of Miami Miller School of MedicineMiamiUSA

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