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人体肾脏活检组织中的镉浓度。

Cadmium concentration in human kidney biopsies.

作者信息

Lindqvist B, Nyström K, Stegmayr B, Wirell M, Eriksson A

机构信息

Department of Internal Medicine, University Hospital, Umeå, Sweden.

出版信息

Scand J Urol Nephrol. 1989;23(3):213-7. doi: 10.3109/00365598909180844.

Abstract

This study reports the cadmium concentration and histopathology of kidney tissue from 29 patients with clinical findings that motivated a diagnostic percutaneous kidney biopsy and/or a history of possible exposure to cadmium. Cadmium was found in all specimens examined including those from controls. In the patients, the mean cadmium concentration was 12.9 (0.6-45.0) micrograms cadmium per g wet kidney tissue. The highest concentrations (30-45 micrograms/g) were found in three patients with morphological and clinical findings of tubulo-interstitial damage. Patients with signs of tubulo-interstitial disease had higher mean cadmium concentrations than those with glomerular changes, and patients with normal blood pressure had higher concentrations than those with diastolic hypertension. In a control group of 22 autopsies, the mean cadmium concentration was 8.7 (2.9-22.4) micrograms/g. The mean difference between the right and the left kidney was 2.3 (0.9-9.6) micrograms/g. Laboratory findings in patients with cadmium nephropathy were nonspecific. Thus, in patients with interstitial nephritis and cadmium exposure, a biopsy for the analysis of kidney cadmium concentration may be motivated. The combination of morphological and clinical findings of interstitial nephritis and a high concentration of cadmium in biopsied kidney tissue indicates cadmium nephropathy.

摘要

本研究报告了29例患者肾脏组织的镉浓度及组织病理学情况,这些患者有促使进行诊断性经皮肾活检的临床症状和/或可能接触镉的病史。在所有检查的标本中都发现了镉,包括对照组的标本。患者肾脏组织中镉的平均浓度为每克湿组织12.9(0.6 - 45.0)微克镉。在3例有肾小管间质损伤形态学和临床症状的患者中发现了最高浓度(30 - 45微克/克)。有肾小管间质疾病体征的患者镉平均浓度高于有肾小球改变的患者,血压正常的患者镉浓度高于舒张压高血压患者。在22例尸检的对照组中,镉平均浓度为8.7(2.9 - 22.4)微克/克。左右肾之间的平均差异为2.3(0.9 - 9.6)微克/克。镉肾病患者的实验室检查结果无特异性。因此,对于有间质性肾炎且接触镉的患者,可能有必要进行活检以分析肾脏镉浓度。间质性肾炎的形态学和临床症状与活检肾脏组织中高浓度镉相结合提示镉肾病。

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