Lead Nephropathy: A Case Report And Review Of The Literature

Year 2019, , 94 - 96, 01.05.2019

Şimal Köksal Cevher Ezgi Çoşkun Yenigün Perihan Perkin Fatih Dede

https://doi.org/10.5505/abantmedj.2019.35492

Abstract

The kidney is a structurally and functionally complex organ that plays an important role in control and regulation of homeostasis with various reabsorptive, secretory, metabolic and endocrine functions. High levels of lead exposure is indicated as a cause of chronic renal injury. Chronic occupational exposure to lead, or consumption of illicit alcohol adulterated with lead, has also been linked to a high incidence of renal dysfunction, which is characterized by glomerular and tubulointerstitial changes resulting in chronic kidney disease, hypertension, hyperuricemia and gout. Here, we aimed to report a patient who has hipertension and high uric asit level and was 6.5 years working for the battery factory with high creatinin levels, and result of renal biopsy intranuclear electron dense deposits were found in some of the round tubular epithelial nuclei.

Keywords

Fanconi syndrome, Chronic kidney disease, Lead poisoning

Kurşun Nefropatisi: Vaka Sunumu ve Literatürün Gözden Geçirilmesi

Abstract

Böbrek, çeşitli reabsorpsiyon, sekresyon, metabolik ve endokrin fonksiyonların düzenlenmesinde ve kontrolünde önemli bir rol oynayan, yapısal ve işlevsel olarak kompleks bir organdır. Yüksek düzeyde kurşun maruziyeti kronik böbrek hastalığının bir nedeni olarak gösterilir. Mesleki nedenlerle kronik kurşun maruziyeti veya içine kurşun karıştırılmış yasadışı alkol tüketimi, kronik böbrek hastalığı ile sonuçlanan glomerüler ve tübülointerstisyel değişiklikler, hipertansiyon, hiperürisemi ve gut ile karakterize böbrek fonksiyon bozukluğu ile yüksek oranda ilişkilidir. Biz burada 6,5 yıldır pil fabrikasında çalışan, hipertansiyonu ve ürik asit yüksekliği olan, kreatinin yüksekliği ile başvuran ve renal biyopsisinde yuvarlak tübül epitelyal nükleusların etrafında intranükleer elektron dense depositler olan etiyolojik açıdan başka bir neden tespit edilememiş bir hastayı tartışmayı amaçladık.

Keywords

Fanconi sendromu, Kronik böbrek hastalığı, Kurşun zehirlenmesi

References

• Bernard BP, Becker CE. Environmental lead exposure and the kidney. Clin Toxicol 1988;26 (1-2) :1-34.
• Goyer RA. Lead toxicity: current concerns. Environ Health Perspect 1993 Apr;100:177-87.
• Batuman V. Lead nephropathy, gout, and hypertension. Am J Med Sci 1993;305 (4) :241-7.
• Ritz E, Wiecek A, Stoeppler M. Lead nephropathy. Contrib Nephrol 1987;55:185-91.
• Cullen MR, Robins JM, Eskenazi B. Adult inorganic lead intoxication; presentation of 31 new cases and a review of recent advances in the literature. Medicine 1983;62 (4) :221–47.
• Soderland P, Lovekar S, Weiner DE, Brooks DR, Kaufman JS. Chronic kidney disease associated with environmental toxins and exposures. Adv Chronic Kidney Dis 2010;17 (3) :254-64.
• Goyer RA. Mechanisms of lead and cadmium nephrotoxicity. Toxicol Lett 1989;46 (1-3) :153-62.
• 8.Cramer K, Goyer RA, Jagenburg R, Wilson MH. Renal ultrastructure, renal function, and parameters of lead toxicity in workers with different periods of lead exposure. Br J Ind Med 1974;31 (2) :113-27.
• Odigie IP, Ladipo CO, Ettarh RR, Izegbu MC. Effect of chronic exposure to low levels of lead on renal function and renal ultrastructure in SD rats. Niger J Physiol Sci 2004;19 (1) :27–32.
• Hommond PB, Lerner SJ, Gartside PS. The relationships of biological indices lead exposure to the health status of worker in a secondary lead smelter. J Occup Med 1980;22 (7) :475–84.
• Pollock CA, Ibels LS. Lead nephropathy- preventable cause of renal failure. Int J Artif Organs 1988;11 (2) :75-8.
• Pollock CA, Ibels LS. Lead intoxication in industry. Med J Aust 1986;145 (11-12) :635-9.
• Davies JM. Long-term mortality study of chromate pigment workers who suffered lead poisoning. Br J Ind Med 1984;41 (2) :170-8.
• Wedeen RP, Maesaka JK, Weiner B, Lipat GA, Lyons MM, Vitale LF et al. Occupational lead nephropathy. Am J Med 1975;59 (5) :630-41.