Chronic toxic nephropathies--diagnosis and management.

As a result of industrial and medical progress, man is exposed to an ever changing array of chemicals, drugs and biological products. The kidneys are extremely vulnerable to chronic toxic effects of these substances. Although acute renal failure, nephrotic syndrome and renal tubular disorders result from acute nephrotoxicity, chronic renal failure with renal failure and hypertension result from chronic nephrotoxicity. Heavy metals, analgesic agents and antimicrobials are the common nephrotoxic substance producing chronic renal disease. Medical management consists of preventive exposure measures and early detection of nephrotoxicity by modern industrial medicine. In addition, early clinical diagnosis with appropriate management may prevent the need for chronic hemodialysis and renal transplantation.