Etiologic factors in lead nephropathy.

The rare occurrence of lead nephropathy in widely differing circumstances has suggested that additional causative factors might be required for its production. Seventeen cases of interstitial nephritis associated with severe chronic lead poisoning were reviewed in an attempt to identify these. Data suggested that alcoholism and preexistent hypertension, and also previous or minor urinary tract disease, may potentiate the injurious effects of lead. We recommend that the diagnosis of lead nephropathy should be a positive one, not one of exclusion, and that stored lead should be removed, particularly in persons with hypertension or previous urinary tract diseases.