Lead nephropathy

Abstract

The role of low-level exposure to environmental nephrotoxins as a cause of chronic renal failure is yet to be established. Epidemiologic and basic research on toxic mechanisms and interactions must be moved into the clinical arena by properly designed studies that may, by necessity, require determination of body lead burden together with clinicopathologic correlations. Finally, the diagnostic methods of the animal toxicology laboratory such as urinary enzyme excretion must be tested clinically. Clinical nephrologists are seemingly irrevocably wedded to the glomerular filtration rate (as estimated by serum creatinine or creatinine clearance) as the only valid measurement of significant renal injury. Development of other methods of assessing renal injury are urgently needed to ascertain whether low-level exposure to nephrotoxins constitutes an important cause of chronic renal failure.