Nephrotoxicity cohorts

Nephropathy has been associated with chronic lead poisoning. " A study of two large cohorts of heavily exposed lead workers followed through 1980 demonstrated a nearly threefold excess of deaths attributed to chronic nephritis or other hypertensive disease, primarily kidney disease. Most of the excess deaths occurred before 1970, among men who began work before 1946, suggesting that current lower levels of exposure may reduce the risk. Experimental animal studies suggest there may be a threshold for lead nephrotoxicity, and in workers, nephropathy occurred only in those with blood levels over 62p,g/dl for up to 12 years."... 

Drug overdose In a retrospective cohort study the presence of gastrointestinal manifestations after paracetamol poisoning predicted a risk of subsequent hepatotoxicity and nephrotoxicity [22 ]. 

General population cohorts for Pb—nephrotoxicity relationships have been studied both in the United States and internationally (Table 15.5). Major U.S. studies have been both cross-sectional and prospective in nature. Non-U.S. studies have largely been cross-sectional in nature, beginning with the first effort for environmental exposures via drinking water Pb in certain areas of Scotland (Campbell et al., 1977). Those researchers found that hyperuricemia was strongly associated with elevated PbB, the latter arising from tap water Pb levels >100 p.g/1. 

Altered early nephrotoxicity markers 32 microglobulin, serum cystatin-C Two child exposure cohort PbB mean values 1.8, 2.7 ig/dl PbB positively associated with both markers ... 

In a retrospective cohort study of 80 patients received vancomycin given either as an intermittent infusion or as a continuous infusion with a similar cumulative dose the prevalence of nephrotoxicity was similar in the two groups (16%) [94 ]. 

Buchholtz K, Larsen CT, Hassager C, Bruun NE. Severity of gentamicin s nephrotoxic effect on patients with infective endocarditis a prospective observational cohort study of 373 patients. Clin Infect Dis 2009 48(1) 65-71. 

In a retrospective case-cohort study in 809 patients who developed contrast-induced nephrotoxicity after either intraarterial or intravenous contrast administration and 2427 patients who did not,... 

Hall RG, Hazlewood KA, Brouse SD, GirUiano CA, Haase KK, Frei CR, et al. Empiric guideUne-recommended weight-based vancomycin dosing and nephrotoxicity rates in patients with methicUUn-resistant Staphylococcus aureus bacteremia a retrospective cohort study. BMC... 

Urinary tract L-AmB nephrotoxicity was evaluated in a cohort of 71 children treated with L-AmB in third-level neonatal intensive care unit (ICU) [Z ]. All children received antifxmgal treatment on average 5 ( 3) days at recommended dosages (3-5 mg/kg per day). Hypokalaemia and/or elevated creatine serum levels, and/or decreased urine output, occurred in 2.8% (2/71) of the cases. In these cases, cessation of L-AmB therapy restored the renal function at discharge. No other significant adverse effects were recorded. The authors concluded that L-AmB is well tolerated in very low birth weight preterm infants. 

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