- Clinically, renal lesions may present as acute renal failure, chronic
renal failure or nephrotic syndrome; and neoplasia especially renal
cell carcinoma.
Heavy Metals As Environmental Nephrotoxins
These include lead, cadmium, mercury, uranium and arsenic.
Moreover, therapeutic forms of gold, bismuth and platinum can cause
nephrotoxicity. Silicon, beryllium, lithium, barium and selenium are not
heavy metals (specific gravity <5) but may cause nephrotoxicity.
Lead nephrotoxicity:
Prior to the industrial revolution the normal total body burden of
lead was 2mg. In a typical modern industrialized society, it is now about
200 mg. About 10-15 per cent of ingested and 40 per cent of inhaled lead
is absorbed.
Exposure:
a) Occupational: metal smelting workers, miners, storage battery workers,
pottery makers, automanufacturers, ship builders, paint manufacturers
and painting industry.
b) Household: lead-glazed pottery, moonshine whisky, lead added to
aphrodisiacs, herbal and folk medicines.
c) Others: retained bullet, leaded gasoline.