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

Ali Mirza Onder, Veronica Espinoza, Mariana E. Berho, Jayanthi Chandar, Gaston Zilleruelo, Carolyn Abitbol

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1760-1764
Number of pages5
JournalPediatric Nephrology
Issue number11
StatePublished - Nov 1 2006


  • Acute renal failure
  • Methemoglobinemia
  • Pyridium® intoxication

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health


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