Pattern of renal diseases among elderly Egyptians patients with acute or chronic renal diseases in Ain Shams University and Nasser Institute Hospitals, Cairo, Egypt.

This study among elderly renal Egyptian patients (n=220) with only 20 of them were subjected to renal biopsy. Results showed: diabetic nephropathy in 28.2%, hypertensive nephrosclerosis 25.5%, UTI, cystitis and pyelonephritis in 6.8%, renal stones in 5.9%, obstructive uropathy in 7.6%, simple cysts in 4.5%, CRF of unknown origin in 13.1%, and others in 26.4%. DM and HTN were S related to kidney function tests and increase in elderly. Other cardiovascular risk factors and smoking are reported by previous workers to be HS related to renal diseases. Age was significantly related to GFR, BUN and Cr. but sex difference was not significantly related to renal diseases. Multiple myeloma, lupus nephritis, vasculitis and hepatitis B were all recorded in few numbers of elderly Egyptians. HCV was more common and more likely to cause renal diseases. Abdomino-pelvic ultrasound was confirmatory to clinical renal diseases diagnosis. Among patients (n=20) biopsies showed focal necrotizing GN in 20%, membranous nephropathy in 50% and renal amyloidosis in 30%. CTIN was associated in some cases due to NSAID intake. Analgesic nephropathy was a common problem that might lead to ARF in some cases especially in the elderly. Ultrasound results among the biopsy group were confirmatory to clinical diagnosis.

Effects of smoking and lead exposure on proximal tubular integrity among Egyptian industrial workers.

BACKGROUND: The hazards of occupational lead exposure are well documented. Tissue damage produced by lead is slow and progressive. The renal system is one of the systems primarily affected by lead. The present study aimed to evaluate renal proximal tubular functional and structural integrity among lead-exposed and cigarette-smoking male Egyptian workers. This study was extended to investigate the effect of lead exposure and cigarette smoking on urinary excretion of copper (Cu) and zinc (Zn). METHODS: Participants included in the present study were 156 male workers grouped as follows: i) 75 lead non-exposed workers subgrouped into G1 that consisted of 36 non-smokers (age, 39.08+/-6.65 years) and G2, which included 39 smokers (age, 43.87+/-9.93 years); ii) 45 lead-exposed workers (work duration <20 years) subgrouped into G3 that consisted of 25 non-smokers (age, 37.40+/-3.76 years) and G4, which included 20 smokers (age, 38.40+/-4.95 years), and iii) 36 lead-exposed workers (work duration > or =20 years) subgrouped into G5 that consisted of 16 non-smokers (age, 45.94+/-4.19 years) and G6 which included 20 smokers (age, 45.70+/-2.25 years). Functional integrity of proximal tubules was studied by determining urinary level of low-molecular-weight protein alpha1-microglobulin (alpha1M), and structural integrity was investigated by measuring urinary activities of the lysosomal enzyme N-acetyl-beta-D-glucosaminidase (NAG) and the cytoplasmic enzyme glutathione S-transferase (GST). Urinary concentrations of Pb, Cu, Zn, and creatinine were also determined. RESULTS: Data of the present investigation showed increased urinary excretion of all measured urinary parameters among lead-exposed workers in comparison with non-exposed workers whether they were non-smokers or smokers (G3 vs. G1, G5 vs. G1, G4 vs. G2, and G6 vs. G2), with greater elevation among lead-exposed smokers than among lead-exposed non-smokers (G4 vs. G3, G6 vs. G5). In addition, there was a greater increase in levels of all urinary parameters among workers with work duration > or =20 years than in those with <20 years' work duration (G6 vs. G4, G5 vs. G3). CONCLUSIONS: Lead exposure in Egyptian workers causes damage to renal proximal tubules and results in its dysfunction. Cigarette smoking has a nephrotoxic effect and also is synergistic to lead nephrotoxicity on urinary excretion of GST and NAG, as well as Pb.