Acute toxic nephropathies: clinical pathologic correlations.

Man's ever increasing exposure to numerous drugs and chemicals, which are the results of medical and industrial progress, produces a by-product of acute toxic nephropathies. These include acute toxic renal failure, drug-induced acute oliguric renal failure, acute hemorrhagic glomerulonephritis, nephrotic syndrome, tubular disturbances and potassium deficiency. In depth information is provided for the previously mentioned disorders.

Chronic toxic nephropathies--diagnosis and management.

As a result of industrial and medical progress, man is exposed to an ever changing array of chemicals, drugs and biological products. The kidneys are extremely vulnerable to chronic toxic effects of these substances. Although acute renal failure, nephrotic syndrome and renal tubular disorders result from acute nephrotoxicity, chronic renal failure with renal failure and hypertension result from chronic nephrotoxicity. Heavy metals, analgesic agents and antimicrobials are the common nephrotoxic substance producing chronic renal disease. Medical management consists of preventive exposure measures and early detection of nephrotoxicity by modern industrial medicine. In addition, early clinical diagnosis with appropriate management may prevent the need for chronic hemodialysis and renal transplantation.

Urinary loss of clotting factors due to hereditary membranous glomerulopathy.

Severe plasma deficiencies of clotting factors IX and XII developed in a 59-year-old woman with a nephrotic syndrome secondary to a laminated membranous glomerulopathy. Both these clotting factors were subsequently identified in the patient's urine. Chromatographic analysis of the urine revealed that the bulk of clotting activity attributed to factors IX ann XII was in early eluting gel filtration fractions containing predominately alpha-2 globulin and albumin. The unprecedented finding of two coagulation proteins in the urine is attributed to the marked proteinuria present in this case.