Nephrotoxicity is defined as adverse effects on the kidney, ureter, or bladder that result from exposure to chemical substances. The kidney not only is the major excretory organ in the body, but also performs nonexcretory functions, such as regulating blood pressure and blood volume. Since the kidneys receive approximately 25 percent of cardiac output, any chemical in systemic circulation is delivered to them in relatively high amounts. This makes the kidney unusually susceptible to the toxic effects of chemicals. Some nephrotoxic agents cause acute injury to the kidney, while others produce chronic changes that can lead to end-stage renal failure or cancer. The consequences of renal failure can be profound, sometimes resulting in permanent damage that requires dialysis or kidney transplantation.
Toxic injury to the kidney is known to occur as a result of occupational, accidental, or therapeutic exposure to certain chemicals. Renal toxicants include halogenated hydrocarbons, such as carbon tetrachloride and trichloroethylene, and the heavy metals cadmium and lead.
For further general information on chemicals and kidney toxicity, see the following references:
Dixon, R. L., ed. Toxicology of the Kidney. Target Organ Toxicology Series. New York: Raven Press, 1981.
Hook, J., and W. Hewitt. Toxic Responses of the Kidney. Chapter 11 in Casarett and Doull's Toxicology, edited by C. Klaassen, M. Amdur, and J. Doull. New York: Pergamon Press, 1996.
International Programme on Chemical Safety (IPCS). Principles and Methods for the Assessment of Nephrotoxicity Associated with Exposure to Chemicals. Environmental Health Criteria, no. 119. Geneva: World Health Organization, 199l.
Landrigan, P.J., R. A. Goyer, T. W. Clarkson, D. P. Sandler, J. H. Smith, M. J. Thun, and R. Wedeen. The Work-Relatedness of Renal Disease. Archives of Environmental Health. 39(3): 225-230. 1984.
Wedeen, R. P. Renal Disease of Occupational Origin. Occupational Medicine. 7(3):449-461. 1992.
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