Only sufficient information will be given to provide a general background against which nephrotoxicity can be framed. In the case of agents where exposure to larger population segments occurs, information may be obtained by using statistical and epidemiological methods to investigate possible nephrotoxicity from such exposures as compared to a non-exposed control group. In current usage, the term "antibiotic" is applied to any medication that kills bacteria or inhibits their growth, regardless of whether that medication is produced by a microorganism or not. Immunohistochemical techniques demonstrate many functional proteins at discrete locations in the kidney, including the glomeruli and the tubular basement membrane, but there are few data on changes in these proteins as a result of nephrotoxicity. This approach also includes the distribution or incorporation of radiolabelled molecules by their interaction with a photographic film laid over the section Bach et al. The non-specificity of routine histopathology has, in fact, been the strength of these methods in the preliminary assessment of chemically induced nephropathies.
In addition, its cells have the potential to bioconvert chemicals and metabolically activate a variety of compounds. Of those patients identified as having chemical-related renal disease, analgesic nephropathy is the most important recognized outcome. Tests designed to assess tissue damage 8. This classification is consistent with previous WHO publications and textbooks of nephrology and pathology and provides a framework for discussing the mechanisms and pathology of nephrotoxicity. Environmental Health Criteria The photographs in Figure 2 were supplied by Dr N. In young individuals nephrotoxicity in terms of tubular necrosis may be compensated for by constant repair, while in older patients this repair capacity may be diminished, resulting in the clinical expression of renal injury Laurent et al. Indeed, there is some indication that chemical exposure could play a much greater influence in the very high incidence of end-stage renal disease encountered in nephrology and dialysis clinics than is currently considered to be the case. Robbins collated the text for IPCS. The most widely used histochemical approach is based on obtaining frozen, fixed frozen, or fixed embedded sections of the kidney that are then used with chromo- or fluoro-phores. The walls of all peritubular capillaries in the kidney are made up of a thin fenestrated endothelium resting on a basal lamina. There are more ascending vessels, all of larger diameter, than descending ones, and this increased volume capacity relates to the removal of excess water from the interstitium and the maintenance of the medullary osmotic gradient shown in Fig. These include those nephropathies caused by cadmium, other environmental heavy metals, and, more recently, the organo-metallic compounds used as therapeutic agents, anti-cancer drugs, cyclosporin, analgesic abuse, and antibiotics. Research results obtained during that period were not shared between the Axis and the Allied powers during World War II and limited access during the Cold War. Urographic contrast media UCM 5. Two federal bills S. Unless the drug or toxic chemical is persistent in tissues, it is usually not possible to confirm or quantify exposure. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Purified penicillin displayed potent antibacterial activity against a wide range of bacteria and had low toxicity in humans. Specific geographical locations may have analgesic abuse problems such as the Winston-Salem area USA. Mechanisms of cellular toxicity 4. A variety of immunodeposits are associated with glomerulopathies including those caused by heavy metals, but these appear to be T-cell mediated. A central core consisting of descending and ascending vasa recta is surrounded by a peripheral layer consisting of a closely intermingled ascending vasa recta and the descending thin limbs of the loops of Henle. The inability to recognize multiple etiologies or confounding factors adds further complexity to the problem. Experimentally induced upper urothelial carcinomas transitional cell carcinomas 7. Factors related to renal function 2.
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