Yver L, Maréchaud R, Picaud D, Touchard G, d'Eyzac A T, Matuchansky C, Patte D
Nouv Presse Med. 1978 May 6;7(18):1541-3.
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.
在一名职业性铅中毒且肾功能正常的患者中，乙二胺四乙酸（EDTA）疗法（1克/24小时）导致大量铅排出（15000微克/24小时），同时引发了急性肾衰竭。乙二胺四乙酸的直接肾毒性作用被排除：肾功能恢复正常后，随后可逐渐增加乙二胺四乙酸的给药剂量（250毫克至1克/24小时），而不会出现任何肾功能障碍。这些发现强烈提示，乙二胺四乙酸动员的铅负荷与急性肾衰竭之间存在密切关系。该病例可归类为急性铅肾病，文献中仅报道过少数几例。特别强调了螯合疗法期间监测铅排泄的重要性。
