Bhalla Vivek, Grimm Paul C, Chertow Glenn M, Pao Alan C
Department of Medicine, Stanford University, California 94304, USA.
Kidney Int. 2009 Apr;75(8):774-9. doi: 10.1038/ki.2009.16. Epub 2009 Feb 11.
Recent outbreaks of nephrolithiasis and acute kidney injury among children in China have been linked to ingestion of milk-based infant formula contaminated with melamine. These cases provide evidence in humans for the nephrotoxicity of melamine, which previously had been described only in animals. The consequences of this outbreak are already severe and will likely continue to worsen. Herein we summarize the global impact of the melamine milk contamination, the reemergence of melamine-tainted animal feed, and potential mechanisms of melamine nephrotoxicity. Large-scale epidemiologic studies are necessary to further characterize this disease and to assess its potential long-term sequelae. This epidemic of environmental kidney disease highlights the morbidity associated with adulterated food products available in today's global marketplace and reminds us of the unique vulnerability of the kidney to environmental insults. Melamine is the latest in a growing list of diverse potentially toxic compounds about which nephrologists and other health-care providers responsible for the diagnosis and management of kidney disease must now be aware.
近期，中国儿童中爆发的肾结石和急性肾损伤事件与食用受三聚氰胺污染的以牛奶为基础的婴儿配方奶粉有关。这些病例为三聚氰胺的肾毒性提供了人体证据，此前三聚氰胺的肾毒性仅在动物中有所描述。此次事件的后果已经很严重，而且可能会继续恶化。在此，我们总结了三聚氰胺污染牛奶的全球影响、受三聚氰胺污染的动物饲料再次出现的情况以及三聚氰胺肾毒性的潜在机制。有必要开展大规模流行病学研究，以进一步明确这种疾病的特征，并评估其潜在的长期后遗症。这场环境性肾病的流行凸显了当今全球市场上掺假食品所带来的发病率，并提醒我们肾脏对环境损害具有独特的易损性。三聚氰胺是越来越多的各种潜在有毒化合物中的最新一种，肾病学家和其他负责肾病诊断和管理的医疗保健人员现在必须对这些化合物有所了解。
