Mercury-associated nephrotic syndrome: a case report and systematic review of the literature.

Author: Miller S, Pallan S, Gangji AS, Lukic D, Clase CM.

Source: Am J Kidney Dis.

Year: 2013

Comment:

This review examines the impact of mercury exposure on the kidneys, as well as using chelation to reduce mercury levels.

Abstract / Excerpt:

“Kidney injury from mercury is known to cause dose-related tubular dysfunction and idiosyncratic nephrotic syndrome according to various case reports. Motivated by a patient with subacute-onset nephrotic syndrome, histologic features of secondary focal segmental glomerulosclerosis, and concurrent mercury toxicity, we conducted a systematic review to explore renal histologic changes in patients with toxic mercury exposures and nephrotic syndrome. Data were extracted from a patient’s clinical record. MEDLINE/Ovid was searched from 1950 to November 2010 using a prespecified search strategy. Two nephrology textbooks and the UpToDate online database also were searched. Inclusion criteria were studies of humans with nephrotic syndrome, nephrotic-range proteinuria, or kidney biopsy results reported. There were no exclusion criteria. We identified 27 other reports of 42 patients with nephrotic syndrome or nephrotic-range proteinuria. Of the 26 individuals, including our patient, who underwent kidney biopsy, histology showed glomerular disease in 21. Of these 20 biopsies, 4 showed minimal change disease and 15 showed membranous glomerulonephritis. Mercury exposure can lead to various glomerular lesions; we emphasize the importance of a careful occupational and dietary history in elucidating a cause for the undetermined nephrotic syndrome.”

Citation:

Miller S, Pallan S, Gangji AS, Lukic D, Clase CM. Mercury-associated nephrotic syndrome: a case report and systematic review of the literature.Am J Kidney Dis. 2013; 62(1):135-8. Review.