Proteinuria gold salts

Pathogenic mechanism of auranofin-induced nephropathy resemble those of parenteral gold-induced nephropathy. The reason for the reduced risk of proteinuria with auranofin compared to parenteral gold salts is not known. However, differences in the pharmacokinetics of the two types of gold preparations may be important. In rats treated with auranofin or sodium aurothiomalate for one year, renal gold concentrations were 33 times higher with the latter formulation [85]. Renal elimination of an orally administered dose of auranofin in human is less than 15%, compared with greater than 70% for parenterally administered sodium aurothiomalate [86]. 

Some drugs such as hydralazine or procainamide may induce lupus like diseases with antinuclear antibodies and proteinuria. D-penicillamine not only causes glomerulopathies, but also myasthenia, polymyositis or lupus, suggesting that this compound provokes immune disregulation. Gold salts also are capable of inducing various immunopathological disorders such as pneumonitis, anemia, thrombocytopenia and hepatitis. 

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