Renal damage

Rats exposed to 500 ppm of bromotrifluoroethylene died following a 4-h exposure. Since the monomer decomposes in air, the level of exposure to it was actually lower. The effects in rats of repeated exposure over a two-week period have been studied. At 50 ppm, the animals lost weight and renal damage was noted although the effect was reversible. Very mild testicular damage was seen at 50 but not 10 ppm. The amount of urinary duotide excreted suggested that extensive metaboHsm was occurring (34). 

Oxalic acid is caustic and corrosive to the skin and mucous membranes. Ingestion may cause severe gastroenteritis with vomiting, diarrhea and melana. Renal damage can occur as result of formation of excessive Ca oxalate. Severe poisoning can end fatally. Tolerance,... 

Because renal impairment is common in older adults the nurse should give the sulfonamides with great caution. There isan increased danger of the sulfonamidescausng additional renal damage when renal impairment is already present. An increase of fluid intake up to 2000 mL (if the older adult can tolerate this amount) decreases the risk of crystals and stones forming in the urinary trad. 

The osmotic diuretics are contraindicated in patients with known hypersensitivity to the drags, electrolyte imbalances, severe dehydration, or anuria and those who experience progressive renal damage after instituting therapy (mannitol). Mannitol is contraindicated in patients with active intracranial bleeding (except during craniotomy). 

Diuretic teas such as juniper berries and shave grass or horsetail are contraindicated. Juniper berries have been associated with renal damage, and horsetail contains severely toxic compounds Teas with ephedrine should be avoided, especially by individuals with hypertension. 

Flores, J., Dibona, D.R., Beck, C.H. and Leaf, A. (1972). The role of ceU sweUing in ischaemic renal damage and the protective effect of hypertonic solute. J. Clin. Invest. 51, 118-126. 

Angiotensin-converting enzyme inhibitors Renal damage, growth restriction... 

Monsanto 1987a, 1987b, 1989), Cellulube 220 (Carpenter et al. 1959), and a triaryl phosphate hydraulic fluid (Siegel et al. 1965). In addition, no evidence of renal damage was observed following intermediate-duration exposure of rats to oral doses of Pydraul 90E (Monsanto 1979), rabbits to topical cyclotriphosphazene (Kinkead et al. 1989c, 1990), or rabbits to topical Cellulube 220 (Carpenter et al. 1959). 

Histopathological evidence of renal damage has been observed in lead-exposed workers. Renal ultrastructure and function were examined in five men with heavy occupational exposure to lead (Cramer et al. 1974). In addition, renal function was evaluated in two men from whom renal biopsies were not obtained. PbB levels ranged from 71 to 138 pg/dL. Renal function tests were normal in all except for a reduced glomerular filtration rate in one worker. Two subjects with relatively short exposure to lead (6 weeks and 8 months) and PbB levels of 89-129 pg/dL had intranuclear inclusions in the proximal tubules. Renal biopsies from workers with longer periods of lead exposure (4-20 years, PbB levels of 71-138 pg/dL) had diffuse interstitial or peritubular fibrosis. Glomeruli were normal in all subjects. 

Tejani A, Lancman L. RajkumarS. 1986. Progressive renal damage due to lead intoxication in early life. Int J Pediatr Nephrol 7 9-12. 

Acute drug-related hypersensitivity reactions (allergic responses) may cause tubulointerstitial nephritis, which will damage the tubules and interstitium. These reactions are most commonly observed with administration of methicillin and other synthetic antibiotics as well as furosemide and the thiazide diuretics. The onset of symptoms occurs in about 15 days. Symptoms include fever, eosinophilia, hematuria (blood in the urine), and proteinuria (proteins in the urine). Signs and symptoms of acute renal failure develop in about 50% of the cases. Discontinued use of the drug usually results in complete recovery however, some patients, especially the elderly, may experience permanent renal damage. 

R. Rodrigo and G. Rivera, Renal damage mediated by oxidative stress a hypothesis of protective effects of red wine. Free Rad. Biol. Med. 33, 409—422 (2002). 

Studies in experimental animals have also shown increased urinary protein accompanied or unaccompanied by histopathological changes of the kidneys following exposure to mirex (NTP 1990) or chlordecone (Larson et al. 1979b). Although these changes are not specific for mirex or chlordecone, measurement of these parameters may provide information about renal damage in exposed populations. 

The concentrations of phosphate and glucose were measured on all samples and the urine samples were subject to detailed protein analysis two small proteins, retinol binding globulin and P-2-microglobulin (P2M), received particular attention. Unfortunately, none of the markers alone or in combination proved to be entirely appropriate, but a rising concentration of P2M was able to identify nearly three-quarters of subjects who subsequently showed some degree of renal damage. 

Human exposure to bromomethane is most likely to occur by inhalation or dermal contact (see Chapter 5). Inhalation exposure may cause neurological, respiratory and renal damage. Dermal contact may cause skin lesions while oral exposure leads to digestive tract mucosal membrane irritation (see Section 2.2). 

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