Acute renal failure in the course of occupational lead intoxication. Chelation therapy responsability
Yver, L.; Maréchaud, R.; Picaud, D.; Touchard, G.; d'Eyzac, A.T.; Matuchansky, C.; Patte, D.
La Nouvelle Presse Medicale 7(18): 1541-1543
1978
ISSN/ISBN: 0301-1518 PMID: 97624 Document Number: 133369
In a patient with occupational plumbism and a normal kidney function, EDTA therapy (1 g/24 h) resulted in a massive lead excretion (15 000 microgram/24 h) together with acute renal failure. A direct nephrotoxic effect of EDTA was excluded: after renal function returned to normal, EDTA could be subsequently readministered at progressively increasing doses (250 mg to 1 g/24 h) without any renal dysfunction. These findings strongly suggest a close relationship between the burden of lead mobilized by EDTA and the acute renal failure. This case can be classified as acute lead nephropathy of which only a few instances have been reported in the literature. The interest of monitoring lead excretion during chelation therapy is particularly emphasized.