Kidney and heavy metals - The role of environmental exposure (Review)

Lentini,Paolo; Zanoli,Luca; Granata,Antonio; Signorelli,Salvatore   Santo; Castellino,Pietro; Dell'Aquila,Roberto

doi:10.3892/mmr.2017.6389

Kidney and heavy metals - The role of environmental exposure (Review)

Authors:
- Paolo Lentini
- Luca Zanoli
- Antonio Granata
- Salvatore Santo Signorelli
- Pietro Castellino
- Roberto Dell'Aquila
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Affiliations: Department of Nephrology and Dialysis, ‘St. Bassiano’ Hospital, I-36061 Bassano del Grappa, Italy, Department of Internal Medicine, University of Catania, I-95124 Catania, Italy, Department of Nephrology ‘St. Giovanni di Dio’ Hospital, I-92100 Agrigento, Italy
Published online on: March 24, 2017 https://doi.org/10.3892/mmr.2017.6389
Pages: 3413-3419

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Abstract

Heavy metals are extensively used in agriculture and industrial applications such as production of pesticides, batteries, alloys, and textile dyes. Prolonged, intensive or excessive exposure can induce related systemic disorders. Kidney is a target organ in heavy metal toxicity for its capacity to filter, reabsorb and concentrate divalent ions. The extent and the expression of renal damage depends on the species of metals, the dose, and the time of exposure. Almost always acute kidney impairment differs from chronic renal failure in its mechanism and in the magnitude of the outcomes. As a result, clinical features and treatment algorithm are also different. Heavy metals in plasma exist in an ionized form, that is toxic and leads to acute toxicity and a bound, inert form when metal is conjugated with metallothionein and are then delivered to the liver and possible causing the kidney chronic damage. Treatment regimens include chelation therapy, supportive care, decontamination procedures and renal replacement therapies. This review adds specific considerations to kidney impairment due to the most common heavy metal exposures and its treatment.

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1	Freundlich HMFL Characteristics of heavy metals. J Phy Chem. 57:385–470. 1906.(In German).
2	Beliles RP: The lesser metals, In: Toxicity of Heavy Metals in the EnvironmentPart 2. Oehme FW: Marcel Dekker; New York, NY: pp. 3831979
3	Sabolić I: Common mechanisms in nephropathy induced by toxic metals. Nephron, Physiol. 104:107–114. 2006. View Article : Google Scholar
4	Barbier O, Jacquillet G, Tauc M, Cougnon M and Poujeol P: Effects of heavy metals on and handling by the kidney. Nephron, Physiol. 99:105–110. 2005. View Article : Google Scholar
5	Lentini P, de Cal M, Clementi A, DAngelo A and Ronco C: Sepsis and AKI in ICU patients: The role of plasma biomarkers. Crit Care Res Pract. 2012:8564012012.PubMed/NCBI
6	Tchounwou PB, Yedjou CG, Patlolla AK and Sutton DJ: Heavy metals toxicity and the environmentMolecular, Clinical and Environmental Toxicology. Luch A: 101. Springer Basel; New York, NY: pp. 133–164. 2012, View Article : Google Scholar
7	Pennemans V, De Winter LM, Munters E, Nawrot TS, Van Kerkhove E, Rigo JM, Reynders C, Dewitte H, Carleer R, Penders J, et al: The association between urinary kidney injury molecule 1 and urinary cadmium in elderly during long-term, low-dose cadmium exposure: A pilot study. Environ Health. 10:772011. View Article : Google Scholar : PubMed/NCBI
8	Granata A, Zanoli L, Clementi S, Fatuzzo P, Di Nicolò P and Fiorini F: Resistive intrarenal index: Myth or reality? Br J Radiol. 87:201400042014. View Article : Google Scholar : PubMed/NCBI
9	Granata A, Zanoli L, Insalaco M, Valentino M, Pavlica P, Di Nicolò PP, Scuderi M, Fiorini F, Fatuzzo P and Bertolotto M: Contrast-enhanced ultrasound (CEUS) in nephrology: Has the time come for its widespread use? Clin Exp Nephrol. 19:606–615. 2015. View Article : Google Scholar : PubMed/NCBI
10	Locatelli C: Italian Manual of Dialysis. Witching; Milano: pp. 533–552. 1999, (In Italian).
11	Lentini P, Poghosyan L and Ronco C: Lead, Heavy Metals and the KidneyCritical Care Nephrology. 2nd. Saunders; Philadelphia: pp. 1705–1711. 2009
12	Seyfart G: Poison Index: Heavy Metals Intoxication. 4th. Pabst Science Publishers; Berlin: pp. 390–410. 1997
13	Aurell M, Svalander C, Wallin L and Alling C: Renal function and biopsy findings in patients on long-term lithium treatment. Kidney Int. 20:663–670. 1981. View Article : Google Scholar : PubMed/NCBI
14	Peces R, Fernández EJ, Regidor D, Peces C, Sánchez R, Montero A and Selgas R: Treatment of acute lithium intoxication with high-flux haemodialysis membranes. Nefrologia. 26:372–378. 2006.(In Spanish). PubMed/NCBI
15	Basnakian AG, Apostolov EO, Yin X, Napirei M, Mannherz HG and Shah SV: Cisplatin nephrotoxicity is mediated by deoxyribonuclease I. J Am Soc Nephrol. 16:697–702. 2005. View Article : Google Scholar : PubMed/NCBI
16	Hofmann G, Bauernhofer T, Krippl P, Lang-Loidolt D, Horn S, Goessler W, Schippinger W, Ploner F, Stoeger H and Samonigg H: Plasmapheresis reverses all side-effects of a cisplatin overdose - A case report and treatment recommendation. BMC Cancer. 6:1–7. 2006. View Article : Google Scholar : PubMed/NCBI
17	Fowler BA: Mechanisms of kidney cell injury from metals. Environ Health Perspect. 100:57–63. 1993. View Article : Google Scholar : PubMed/NCBI
18	Wu X, Jin T, Wang Z, Ye T, Kong Q and Nordberg G: Urinary calcium as a biomarker of renal dysfunction in a general population exposed to cadmium. J Occup Environ Med. 43:898–904. 2001. View Article : Google Scholar : PubMed/NCBI
19	Aposhian HV, Maiorino RM and Dart DC: Biochemical toxicology of arsenic. Rev Biochem Toxicol. 10:265–271. 1989.
20	Clarkson TW, Magos L and Myers GJ: The toxicology of mercury - Current exposures and clinical manifestations. N Engl J Med. 349:1731–1737. 2003. View Article : Google Scholar : PubMed/NCBI
21	Zalups RK: Molecular interactions with mercury in the kidney. Pharmacol Rev. 52:113–143. 2000.PubMed/NCBI
22	Pai P, Thomas S, Hoenich N, Roberts R, House I and Brown A: Treatment of a case of severe mercuric salt overdose with DMPS (dimercapo-1-propane sulphonate) and continuous haemofiltration. Nephrol Dial Transplant. 15:1889–1890. 2000. View Article : Google Scholar : PubMed/NCBI
23	Patrick L: Lead toxicity, a review of the literature. Part 1: Exposure, evaluation, and treatment. Altern Med Rev. 11:2–22. 2006.PubMed/NCBI
24	Loghman-Adham M: Renal effects of environmental and occupational lead exposure. Environ Health Perspect. 105:928–938. 1997. View Article : Google Scholar : PubMed/NCBI
25	Pedersen RS: Lead poisoning treated with haemodialysis. Scand J Urol Nephrol. 12:189–190. 1978. View Article : Google Scholar : PubMed/NCBI
26	Kiss JE, Berman D and Van Thiel D: Effective removal of copper by plasma exchange in fulminant Wilsons disease. Transfusion. 38:327–331. 1998. View Article : Google Scholar : PubMed/NCBI