The following is information on renal toxicity, one of the 15 health conditions covered by the VA for Camp Lejeune victims. The information comes courtesy of Kidney.org:
Nephrotoxic injury is damage to one or both of the kidneys that results from exposure to a toxic material, usually through ingestion.
The kidneys are the primary organs of the urinary system, which purifies the blood by removing wastes from it and excreting them from the body in urine. The kidneys filter about 45 gal (180 l) of blood daily. Because of this high volume, the kidneys are more often exposed to toxic substances in the blood and are very vulnerable to injury from those sources. Acute renal failure can occur. The kidneys suddenly lose their ability to function. The alternative is chronic renal failure, in which kidney function slowly deteriorates. If unchecked, renal failure can result in death.
Causes and symptoms
Several different substances can be toxic to the kidneys. These include:
- antibiotics, primarily aminoglycosides, sulphonamides, amphotericin B, polymyxin, neomycin, bacitracin, rifampin, trimethoprim, cephaloridine, methicillin, aminosalicylic acid, oxy- and chlorotetracyclines
- analgesics, including acetaminophen (Tylenol), all nonsteroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen), all prostaglandin synthetase inhibitors
- contrast agents used in some diagnostic tests, such as sodium iodide
- heavy metals, such as lead, mercury, arsenic, and uranium
- anti-cancer drugs, such as cyclosporin, cisplatin, and cyclophosphamide
- methemoglobin-producing agents
- solvents and fuels, such as carbon tetrachloride, methanol, amyl alcohol, and ethylene glycol
herbicides and pesticides
- overproduction of uric acid
- Underlying kidney disease
- Severe dehydration
- Prolonged exposure to heavy metals or solvents
- Presence of diseases that cause the overproduction of uric acid
Symptoms depend upon the type of toxin involved. Symptoms can include azotemia, anemia, acidosis, overhydration, and hypertension. If symptoms go unchecked, more serious symptoms may occur, including seizures and coma.
Through a combination of physical examination, blood tests, urine tests, and imaging procedures, diagnosis of nephrotoxic injury as the underlying cause results from a thorough investigation of the patient’s history.
Treatment takes place in the hospital and focuses on removing the toxin from the patient’s system, while maintaining kidney function. Removal methods are targeted to specific toxins and may include the use of diuretics or chelates to enhance excretion of the toxin in urine, or, in extreme cases, the direct removal of toxins from the blood via hemodialysis or passing the blood over an absorbent substance such as charcoal. Support of kidney function depends on the extent of damage to the organs and ranges from monitoring fluid levels to dialysis.
In cases where damage has not progressed beyond acute renal failure, kidney function can be fully restored once the toxin is removed from the system and equilibrium restored. However, if permanent damage has resulted in chronic renal failure, lifelong dialysis or a kidney transplant may be required.
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