Edit concept Question Editor Create issue ticket

Chronic Lead Nephropathy


Presentation

  • Dumitriu , Ana Roventa Clinic of Occupational Diseases, Institutul de Igienă, Bucharest, Roumania Abstract This paper presents a study of renal function in 102 patients with lead poisoning admitted to the Occupational Diseases Clinic in Bucharest during[oem.bmj.com]
  • Part II presents an over public are concerned about the adverse effects of view of chemical and physical agents commonly toxic agents found in contaminated air, water, food, found in contaminated air, water, food, and soil. and soil.[books.google.com]
  • Alternatively, it may develop over several years - presenting with hypertension and proteinuria sometimes. Ciclosporin This can cause acute and chronic nephrotoxicity.[patient.info]
  • The renal evaluation of patients thought to have renal disease associated with an environmental or occupational exposure should be guided by the history, physical examination, and clinical presentation of the renal disease.[accessmedicine.mhmedical.com]
Physician
  • This clinically oriented reference focuses on diagnosis and treatment of specific diseases, disorders, and complications and incorporates the basic science practicing physicians need to evaluate and manage the disease process.[books.google.com]
  • The products are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients potentially exposed to hazardous substances.[atsdr.cdc.gov]
  • No Doctor/Patient relationship shall be deemed to have arisen simply by reading the information contained on these pages, and you should consult with your personal physician/care giver regarding your medical treatment before undergoing any sort of treatment[drcalapai.net]
  • American College of Physicians Complete Home Medical Guide. Goldmann DR, editor. 1999. New York: DK Publishing, Inc. Pp. 694-708, 1037. Harvard Medical School Family Health Guide. Komaroff I. 1999. New York: Simon & Schuster, Pp. 810-825.[labtestsonline.it]
  • Who to see Health professionals who can diagnose and treat chronic kidney disease include: Family medicine physicians . Internists . Kidney specialists ( nephrologists ). Pediatricians . Nurse practitioners . Physician assistants (PA) .[northshore.org]
Weight Loss
  • loss or skin diseases) Moderate proteinuria, glucosuria, no abnormalities of urinary sediment; severe anemia; diagnosis confirmed by detection of metabolites of aristolochic acid in DNA of renal cells; rapid GFR impairment, which may be partially inhibited[empendium.com]
  • Idiopathic - found associated with anterior uveitis or iritis (tubulointerstitial nephritis with uveitis (TINU)) syndrome affecting mainly young women and girls - fever, weight loss and renal failure. [ 9 ] Presenting features Sudden onset acute kidney[patient.info]
  • Weight loss Loss of lean body mass Protein-energy malnutrition due to metabolic acidosis. Loss of kidney function results in impaired H secretion from the body.[pathophys.org]
  • Symptoms of Chronic Lead Toxicity: • Then complicated with - Intermittent abdominal cramping, vomiting, and constipation - Loss of appetite and diminished libido - Weight loss and anemia and increase in systolic blood pressure. - Tremors and peripheral[slideshare.net]
  • If you have uncontrolled weight loss, discuss this with your doctor during your next visit. Watchful waiting A wait-and-see approach is not a good idea if you could have chronic kidney disease. See your doctor.[northshore.org]
Falling
  • Rejecting or recoding measurements that fall below an instrument’s MDL can yield results that are artificially biased ( 34 ).[clinchem.aaccjnls.org]
  • When kidney function falls below a certain point, it is called kidney failure . Kidney failure affects your whole body. It can cause serious heart, bone, and brain problems and make you feel very ill.[northshore.org]
  • […] concentrating mechanism located in the medulla Occurs early in the course Associated: nocturia, polyuria and nephrogenic diabetes insipidus (NDI) with complications of dehydration Sodium wasting Difficulties in reabsorbing salt, leading to a reversible fall[renalandurologynews.com]
Family History of Gout
  • In order of importance, these were: a childhood history of acute lead poisoning, a history of gout, a family history of gout and detectable XRF finger bone lead.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Clinical presentation • Nausea, persistent vomiting, diarrhea, and abdominal pain are the hallmark of most acute metal ingestions. • Dehydration is common.[slideshare.net]
  • Findings consisted of recurrent abdominal pain and grayish discoloration of the gingival tooth border consistent with 'lead line', with elevated blood lead level.[sjkdt.org]
  • Other clinical manifestations include haemolytic anaemia, acute attacks of gout, intense abdominal pain (“painter’s colic”) and encephalopathy. 43 Diagnosing chronic nephritis due to Pb is difficult, since urinary symptoms and findings are variable and[revistanefrologia.com]
  • Clinical Presentation: Acute intoxication More common in children Abdominal pain, Neurologic symptoms and Pallor (microcytic anemia) Associated Fanconi’s syndrome Renal biopsy: acid-fast granular intranuclear inclusions (myeloid bodies) in the proximal[renalandurologynews.com]
Loss of Appetite
  • When symptoms of kidney damage do occur, they may include significantly decreased urine production, swelling in the lower legs and ankles, hypertension, loss of appetite, muscle cramps, fatigue, digestive upset, and dry, itchy skin.[larcusa.org]
  • . • With exposure to high levels of lead (acute), patients develop Abdominal pain, loss of appetite, vomiting, constipation, headache, ataxia, somnolence, lethargy, seizures, stupor, coma • Acute lead nephropathy is usually completely reversible with[slideshare.net]
  • Call your doctor immediately if you: Have symptoms of uremic syndrome , such as increasing fatigue, nausea and vomiting, loss of appetite, or inability to sleep. Vomit blood or have blood in your stools.[northshore.org]
Hypertension
  • Arterial hypertension accompanied the chronic renal failure in 13 patients, the renal impairment generally preceding the rise in blood pressure by several years.[oem.bmj.com]
  • The remaining twelve sections cover various types of diseases, including hypertension, urological problems, and urinary tract concerns.[books.google.com]
  • Lead-induced hypertension: Role of oxidative stress. Curreent Hypertension Reports 2004; 6: 314-320. CrossRef Google Scholar 40. Staessen J, Lauwerys RR, Buchet J-P, Bulpitt CJ, Rondia D, Vanenterghem Y, Amery A.[link.springer.com]
  • Gout is actually quite rare in other forms of CKD, so the appearance of gout and CKD together should prompt screening for serum lead levels. 3. lead-induced hypertension--lead can lead to renal disease indirectly by causing hypertension--a finding which[renalfellow.blogspot.com]
  • Hypertension, of relatively new onset, is present in most patients. Lead and hypertension Epidemiologic evidence has linked hypertension with lead poisoning.[emedicine.medscape.com]
Heart Disease
  • This edition has new lead authors for more than 25 chapters, and separate chapters on heart disease and the kidney, liver disease and the kidney, and the nephrotic syndrome.[books.google.com]
  • Diabetes management : Tight glucose management slows the progression of vascular and heart disease.[pathophys.org]
  • Heart disease . Chronic kidney disease speeds up hardening of the arteries ( atherosclerosis ) and increases the risk of stroke, heart attack, and heart failure . Heart disease is the most common cause of death in people with kidney failure.[northshore.org]
Renal Insufficiency
  • Measurements: The reciprocal of serum creatinine (1/Cr) was used as an index of progressive renal insufficiency.[annals.org]
  • Repeated chelation therapy may improve renal function and slow the progression of renal insufficiency.[nejm.org]
  • However, chronic low-level exposure may cause renal insufficiency and hypertension independent of tubulointerstitial disease.[merckmanuals.com]
  • The patient was prescribed angiotensinconverting-enzyme inhibitors to slow the progression of renal insufficiency and control the blood pressure. Hyperuricemia was also treated and controlled.[sjkdt.org]
  • The patient was prescribed angiotensin-converting-enzyme inhibitors to slow the progression of renal insufficiency and control the blood pressure. Hyperuricemia was also treated and controlled.[ncbi.nlm.nih.gov]
Nocturia
  • Type or etiology Causes/risk factors Features Analgesic nephropathy Excessive analgesic use 3 y in various combinations, including NSAIDs; more frequent in women Hypertension, nocturia, sterile leukocyturia, hemolytic anemia; characteristic papillary[empendium.com]
  • Urinary concentration defects (secondary to dysfunction of the kidney concentrating mechanism located in the medulla Occurs early in the course Associated: nocturia, polyuria and nephrogenic diabetes insipidus (NDI) with complications of dehydration Sodium[renalandurologynews.com]
Renal Impairment
  • Arterial hypertension accompanied the chronic renal failure in 13 patients, the renal impairment generally preceding the rise in blood pressure by several years.[oem.bmj.com]
  • Clinical Manifestations: Low to normal BP Polyuria 2nd to NDI Typically seen with chronic K depletion ( 3.0 mEq/L) Minimal proteinuria Majority have reduced eGFR and azotemia Severity of renal impairment correlated with duration and degree of potassium[renalandurologynews.com]

Workup

  • Kashani, Biomarkers for Early Detection of Acute Kidney Injury, The Journal of Applied Laboratory Medicine: An AACC Publication, September 2017, jalm.2017.023325; DOI: 10.1373/jalm.2017.023325 (May 1, 2017) Arora, P Chronic Kidney Disease Workup.[labtestsonline.it]
Uric Acid Increased
  • Obermayr, RP, Temml, C, Gutjahr, G, Knechtelsdorfer, M, Oberbauer, R, Klauser-Braun, R. ” Elevated uric acid increases the risk for kidney disease”. J Am Soc Nephrol. vol. 19. 2008. pp. 2407-2413.[renalandurologynews.com]

Treatment

  • This clinically oriented reference focuses on diagnosis and treatment of specific diseases, disorders, and complications and incorporates the basic science practicing physicians need to evaluate and manage the disease process.[books.google.com]
  • The oppor- nity to share in the rich diversity of the international We are encouraged by the accumulation of rec- scientific community remains a fundamental goal of nized risk factors, which allow pre-treatment strati- this endeavor.[books.google.com]
  • No Doctor/Patient relationship shall be deemed to have arisen simply by reading the information contained on these pages, and you should consult with your personal physician/care giver regarding your medical treatment before undergoing any sort of treatment[drcalapai.net]
  • After the 2-month treatment period, improvement in renal function was greater in the treatment group than in the control group.[annals.org]
  • Think about your treatment options and which kind of treatment will be best for you.[northshore.org]

Prognosis

  • Prognosis Renal function stabilises or improves slightly on discontinuation of analgesics in early cases.[patient.info]
  • […] diagnosis of CKD requires the following: Decline of kidney function for 3 months or more AND Evidence of kidney damage (e.g. albuminuria or abnormal biopsy) OR GFR 2 Each patient is classified into one of the following 5 stages of CKD because management and prognosis[pathophys.org]
  • Prognosis: Rapid progression to ESRD (6 months — 2 years) CLINICAL PEARL: High prevalence of Urothelial Malignancies (40-50%) of: Upper urinary tract (multifocal high-grade transitional cell carcinoma) and bladder ** Most commonly detected in pts with[renalandurologynews.com]

Etiology

  • The etiology of the kidney injury in a significant percentage of these patients is never fully elucidated, and the diagnosis of renal disease of occupational origin is rarely considered.[accessmedicine.mhmedical.com]
  • Type or etiology Causes/risk factors Features Analgesic nephropathy Excessive analgesic use 3 y in various combinations, including NSAIDs; more frequent in women Hypertension, nocturia, sterile leukocyturia, hemolytic anemia; characteristic papillary[empendium.com]
  • […] increased GFR ( 90 mL/min/1.73 m 2 ) Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m 2 ) Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m 2 ) Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m 2 ) Stage 5: Kidney failure (GFR 2 or dialysis) Etiology[pathophys.org]
  • […] in only a small proportion of patients Renal biopsy – granulomatous inflammatory infiltrate is confined to the cortex (versus drug-induced interstitial nephritis, predilection for corticomedullary junction (Figure 2) Need to consider other potential etiologies[renalandurologynews.com]

Epidemiology

  • Am J Epidemiology 2002; 156(12):1079-1087 CrossRef Google Scholar 57. Vigeh M, Ghazizadeh S, Yokayama K, Sakai T, Mazaheri M, Morita Y, Beheshti S, Kitamura F, Araki S.[link.springer.com]
  • This metal gradually accumulates in the body and levels increase with age given its long half-life, which is more than 20 years. 7 Epidemiology Various epidemiological studies have demonstrated that environmental exposure to Cd increases the risk of developing[revistanefrologia.com]
  • […] other forms of CKD, so the appearance of gout and CKD together should prompt screening for serum lead levels. 3. lead-induced hypertension--lead can lead to renal disease indirectly by causing hypertension--a finding which has been confirmed in numerous epidemiologic[renalfellow.blogspot.com]
  • Epidemiology United States statistics Toxic nephropathies are estimated to cause fewer than 1% of all cases of end-stage kidney disease.[emedicine.medscape.com]
  • Treatment of low-level data varies depending on whether they are intended for use in a clinical setting or for epidemiological research.[clinchem.aaccjnls.org]
Sex distribution
Age distribution

Pathophysiology

  • Each disease-oriented section begins with an up-to-date review of pathophysiology and then focuses on specific diseases.[books.google.com]
  • We have stressed the cont- true to our concept of a multi-national author book. bution of cell biology and pathophysiology, were it We continue to believe that scientific information is an exists, believing it provides both a better understa- international[books.google.com]
  • These factors help to explain the pathophysiologic mechanisms involved in certain toxins. For example, lead and cadmium cause much of their renal ultrastructural damage in the proximal tubule, where two-thirds of the filtered load is reabsorbed.[accessmedicine.mhmedical.com]
  • Pathophysiology • The pathophysiology of the heavy metal remains relatively constant. • For the most part, heavy metals bind to oxygen, nitrogen, and sulfhydryl groups in proteins, resulting in alterations of enzymatic activity. • Nearly all organ systems[slideshare.net]
  • Pathophysiology Nephrol Dial Transplant. 2002 May;17(5):723-31 Semin Neurol. 2011 Apr;31(2):139-43 Lancet. 2012 Jan 14;379(9811):165-80 Patients with stages 1-3 ([GFR] 30 mL/min) of CKD are generally asymptomatic; water/electrolyte imbalances or endocrine[pathophys.org]

Prevention

  • The sharing of in- cus our preventative techniques on the individuals tellectual resources fostered by this effort should and most likely to gain the greatest benefit.[books.google.com]
  • Special attention should be paid to renal function tests in all cases with prolonged exposure to lead in order to prevent the development of severe lead nephropathy.[oem.bmj.com]
  • Primary prevention of lead exposure is the most important and significant strategy to protect children and adults from lead exposures.[atsdr.cdc.gov]
  • The American Public Health Association, Recognizing that exposure to lead is universal as a result of human-caused disturbances in the natural distribution of lead, and that elevation in the body burden of lead is one of the most prevalent causes of preventable[apha.org]
  • However, these exposures represent potentially preventable causes of chronic kidney disease.[accessmedicine.mhmedical.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!