Symptoms of Nephropathy

The extent and cost of clinically relevant nephrotoxicity has only started to become apparent dnring the last decade. However, the fnll extent of the economic impact of chemically indnced or associated nephropathy is difficnlt to define becanse the diagnosis of early injnry and the documentation of the cascade of secondary degenerative changes have not been adequately identified. Instead, most chemically associated renal disease is only identified as acnte renal failnre or chronic renal failnre at a very late stage, when therapeutic intervention is impossible. 

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. 

The nephron and its related cells perform diverse physiological functions. It is the major organ of excretion and homeostasis for water-soluble molecules because it is a metabolically active organ, it can concentrate certain substances actively. In addition, its cells have the potential to bioconvert chemicals and metabolically activate a variety of compounds. There are a number of other processes described in the following that establish the potential for cellular injury. Specific physiological characteristics are localized to specific cell types. This makes them susceptible to, and the target for, chemicals. 

The effect of chemical substances on cells may be pharmacological, in which case the effect is dose related and occurs only as long as the concentration of the chemical snbstance is high enough to be active. Alternatively, the chemical substance 

The array of industrial chemicals, negligence during use, and the long-term health consequences need to be understood by workers. The rational understanding of the mechanism of nephrotoxicity in animals and man provides the basis for safe use. Reports of Kluwe et al. and Porter and Bennett indicate the type of adverse health effects vis-a-vis nephrotoxicity caused by aminoglycosides, halogenated hydrocarbons and aromatic amines produce chronic kidney injury in humans and species of mammals. 

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