How to judge whether it is heavy metal toxic nephropathy?

summary

Heavy metal toxic nephropathy is an acute and chronic renal injury caused by long-term exposure to heavy metals. Metals can be divided into heavy metals and light metals according to their density. Those with density more than 4.5kg/m3 are called heavy metals (generally refer to metal elements with specific gravity more than 5). Heavy metal toxic nephropathy is closely related to occupational and environmental exposure to heavy metals. Most heavy metals are nephrotoxic. How to judge whether it is heavy metal toxic nephropathy? Next, I'd like to share my views with you.

How to judge whether it is heavy metal toxic nephropathy?

No history of heavy metal exposure, mainly due to a variety of congenital renal proximal convoluted tubule reabsorption function defects, resulting in glomerular filtration fluid glucose, amino acids, calcium, phosphorus and sodium bicarbonate reabsorption obstacles.

Gout occurs after hypertension, and chronic renal failure occurs more quickly. The increase of lead excretion in EDTA mobility test can confirm the diagnosis of lead nephropathy. The urine lead excretion of non-contact patients without lead storage in tissues was generally less than 3.14% μ mol/24h。 In patients with chronic renal failure, urine can be collected for 3-4 days. If the patient is lead-free, the urine lead excretion should not be more than 3.14 μ mol。 X-ray fluorescence analysis can determine bone lead content. The presence of eosinophilic inclusions in the nuclei of proximal tubules by renal biopsy or urine sediment examination may also help to establish the diagnosis.

For patients with a history of exposure to certain heavy metals, abnormal urine test, changes in renal function, positive urine sugar, elevated amino acid urine, elevated urinary calcium and phosphorus, and extrarenal manifestations of heavy metal poisoning, the disease can be diagnosed if the content of certain heavy metals in urine exceeds the normal value.

matters needing attention

The key of heavy metal poisoning lies in prevention. Avoiding contact with all kinds of heavy metals which are easy to cause acute toxic liver and kidney damage can effectively prevent the occurrence of the disease; Once symptoms appear, contact should be stopped immediately. The patients with acute poisoning should be treated with gastric lavage, antidote and emergency dialysis immediately to prevent the aggravation of systemic and renal damage leading to acute death.