Acute kidney failure is a common condition affecting approximately 8.3% of outpatient patients and up to 32% of hospitalized individuals. It presents with abdominal or lower back pain, nausea, and vomiting, and requires immediate hospitalization for dialysis. Unlike chronic kidney failure, acute kidney failure refers to a temporary and reversible kidney dysfunction, caused by hemorrhage, septicemia, drug poisoning, or urinary tract obstruction. Another factor has recently been suspected: Brazilian smoothing products containing glyoxylic acid.
These hair care products had already been implicated in a report published in 2023, which listed 26 patients treated in 14 medical centers in Israel between 2019 and 2022 for acute kidney failure. All these hospitalizations followed exposure to Brazilian smoothing products. Among these patients, seven (26%) underwent kidney biopsies, revealing intratubular deposits of calcium oxalate in six of them, suggesting a potential link with exposure to glyoxylic acid.
After glyoxylic acid enters the bloodstream, it is metabolized into oxalic acid by the enzyme lactate dehydrogenase found in the cytoplasm of liver cells (hepatocytes). At a physiological pH of 7.4, the oxalic acid then dissociates to form oxalate ions, which can precipitate as calcium oxalate crystals in the renal tissues, compounds that damage the kidneys.
The toxicity of glyoxylic acid and its ability to penetrate the skin barrier were notably demonstrated in a recent study conducted on rats. Four groups of five rats were formed, on which various creams were tested: a Brazilian smoothing product containing, among other things, 10% glyoxylic acid, a cream containing 10% glyoxylic acid, another cream containing 10% glycolic acid, an active ingredient sometimes accused of having the same level of danger as glyoxylic acid, and a control cream.
Scientists have observed that the applications of glyoxylic acid cream and hair straightening product significantly increased urinary oxalate excretion and caused a calcium oxalate nephropathy after transcutaneous absorption, unlike glycolic acid and the control. These increases are visible in the figure below in the "Urine oxalate" and "COM crystals in urine" histograms, the latter referring to the concentration of calcium oxalate crystals present in the urine. It is interesting to note that these crystals are only present in the rats of the "hair straightening product" and "10% glyoxylic acid cream" groups, which seems to confirm the theory that this active ingredient penetrates the skin before reaching the kidneys.