Pelepenko Lauter E, Janini Ana Cristina P, Gomes Brenda P F A, de-Jesus-Soares Adriana, Marciano Marina A
Department of Restorative Dentistry, School of Dentistry of Piracicaba, State University of Campinas, Av. Limeira, 901, Areião, Piracicaba 13414-903, SP, Brazil.
Antibiotics (Basel). 2022 Dec 2;11(12):1741. doi: 10.3390/antibiotics11121741.
The effects of bismuth toxicity on the kidney-the main organ responsible for blood filtration-were systematically reviewed. This review was motivated by availability of several sources of bismuth in contact with humans including environmental, medications, dental materials, and cosmetics, potentially leading to kidney filtration of this chemical. No previous studies have systematically reviewed the literature considering this association. A total of 22 studies with a total of 46 individuals met the inclusion criteria, 19 being case reports with only one patient enrolled. The included studies publication dates ranged from 1961 to 2021 and the countries of publication were the United States of America, United Kingdom, Germany, Turkey, Switzerland, and Canada. Bismuth sources affecting the kidneys were uniquely reported as from medical purposes and mostly associated to overdoses with several symptoms, apparently with dose-dependent consequences. Patient history of renal impairment seemed to affect the outcome of the case. Several therapies were conducted following bismuth intoxication, and few studies performed renal biopsies describing its histological findings. It is crucial to reconsider the nephrotoxicity of bismuth compounds, mainly in patients with previous history of renal impairment.
对铋毒性对肾脏（负责血液过滤的主要器官）的影响进行了系统综述。此次综述的起因是，包括环境、药物、牙科材料和化妆品在内的多种与人类接触的铋源的存在，可能导致这种化学物质经肾脏过滤。此前没有研究对考虑这种关联的文献进行系统综述。共有22项研究、46名个体符合纳入标准，其中19项为病例报告，每项仅纳入1例患者。纳入研究的发表日期从1961年至2021年，发表国家有美利坚合众国、英国、德国、土耳其、瑞士和加拿大。影响肾脏的铋源唯一被报告来自医疗用途，且大多与过量用药及多种症状相关，显然具有剂量依赖性后果。肾功能损害的患者病史似乎会影响病例结果。铋中毒后进行了多种治疗，很少有研究进行肾活检并描述其组织学结果。重新审视铋化合物的肾毒性至关重要，尤其是对有肾功能损害既往史的患者。
