Cadmium nephropathy

Emerson BT Ouch-ouch disease The osteomalacia of cadmium nephropathy. Ann Intern Med 73 854-855, 1970... 

Transferrin, fhe iron-transporting protein, occurs in urine at concentrations that are about 15 times lower fhan that of albumin. The protein has a shghtly larger effective molecular radius (around 4.0 run) than albumin (3.6 run). Its detection in fhe urine allows a more sensitive indicator of early glomerular involvement in some nephropathies such as cadmium nephropathy. A strong association has been found between the presence of albumin and transferrin in fhe urine of patients with fhe nephrotic syndrome. In these patients, increased transferrin synthesis is insufficient to compensate for urinary losses and plasma levels are reduced [94]. 

The functional changes in chronic lead nephropathy appear to be less specific than those observed in acute poisoning. As in other forms of interstitial nephritis, proteinuria and glycosuria are initially absent. In contrast to cadmium nephropathy, the excretion of a large array of urinary marker proteins such as retinal binding protein, lysozyme, and iriicroglobulin [33, 34] is not increased in the absence of a reduced GFR. 

Effects of non-occupational exposure to cadmium [51], itai-itai disease in particular [52, 53], were occasionally compared with kidney damage seen in Balkan nephropathy patients. In spite of some resembhng features, the idea of a common etiology between cadmium nephropathy (including itai-itai disease) and Balkan nephropathy was refuted [52, 54]. 

Chemical insnlt to the kidney presents a wide spectrum of nephropathies that are indistingnishable from those that do not have a chemical etiology, and the diseases associated with exposure to chemical substances have remained unrecognized. Examples inclnde the nephropathies caused by cadmium, other environmental heavy metals, the organometallic compounds used as therapeutic agents, anticancer drugs, cyclosporin, analgesic abuse, and antibiotics. 

Piscator M.The nephropathy of chronic cadmium poisoning. In Cadmium. Foulkes EC (editor). Springer-Verlag, Berlin 1986 p. 179-194. 

Balkan nephropathy is non-destructive and noninflammatory tubulointerstitial renal disease [69]. The changes are non-specific and in the chronic, sclerotic phase they may be quite similar to changes observed in other chronic interstitial diseases such as analgesic nephropathy [70], vascular nephrosclerosis [69] cyclosporine-induced nephropathy [71], radiation nephritis [72,73] and aging [72], intoxication with silicate, cadmium, lead, uranium [74], mycotoxin ochratoxin... 

PiscatorM, Kostial K, Plestina R. Urinary excretion of cadmium and zink among women with Balkan endemic nephropathy.Trace Elements Med. 1984 1 134-8. 

Wedeen RP. Environmental renal disease Lead, cadmium and Balkan endemic nephropathy. Kidney Int 1991 40 (suppl. 34) S4-8. 

Cadmium, a waste product from several industrial processes, is the cause of itai-itai ( ouch-ouch ) disease, which is characterized by osteomalacia with painful fractures of affected, bones and by nephropathy with an excretory pattern similar to that seen in Fanconi s syndrome. In... 

Thun MJ, Osorio AM, Schober S, Hannon WH and Halperin W (1989) Nephropathy in cadmium workers — assessment of risk from airborne occupational cadmium exposure. Br J Ind Med 46 689—... 

---