Magle Stora Kyrkogata 9, S 22350 Lund, Sweden
* Corresponding author E-mail: firstname.lastname@example.org
Glomerulonephritis is seen as a serious immunologic disease of the glomeruli. However, permanent renal damage has never been produced experimentally by immunisation without the concomitant use of Freund’s adjuvant or other tubulotoxic chemicals. Also contradictory is that renal failure is strongly associated with the degree of tubulointerstitial damage, both in experimental and human glomerulonephritis, whereas weak or no association at all has been found with the degree of glomerular damage. There is solid clinical and experimental evidence that the exposure to tubulotoxic chemicals alone is able to produce glomerulonephritis and renal failure, and there is increasing evidence that such exposure is a major cause of renal failure in other kidney diseases. The aim of this review was to discuss the role of tubulotoxic chemicals in renal failure.
As several studies have observed improvement of renal function after cessation of hydrocarbon exposure, it is reasonable to expect that avoiding other types of toxic exposure may be beneficial as well. It should therefore be mandatory to ask all the patients with renal failure about possible exposure to tubulotoxic chemicals, preferably by experienced occupational hygienists, and to support attempts to avoid such exposure.