Lead Induced Nephrotoxicity: Kidney Calcium as an Indicator of Tubular Injury
Chronic nephropathy is one of the oldest recognized health effects of lead; yet less is known about dose and renal effects than for any of the other major health effects of lead. Some of the reason for this is that chronic renal disease from lead exposure does not become evident until late in life and usually after many years of excessive exposure. At that time exposure information may not be available. In fact, the role of lead may not be recognized since the pathological changes in the late stages are not specific so that it is difficult to differentiate lead nephropathy from any other form of chronic renal failure. The succession of morphological and functional changes characteristic of renal effects of lead have been determined from studies of animal models and workmen exposed to lead. In this brief review a sequence of pathological changes is described comparing similarities and differences in experimental models and man. Current studies to identify biologic markers or diagnostic criteria for the early recognition of lead nephropathy are also reviewed. Finally, results of recent studies in animals will be presented that suggest that there is a threshold level of lead exposure for the onset of acute renal tubular cell effects to occur and that these observations are consistent with the few reported observations of minimal renal lead effects in humans.
KeywordsLead Exposure Blood Lead Level Renal Effect Chronic Renal Disease Renal Tubular Cell
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