“Mercury and the Kidney”
G. Kazantzis, Senior Lecturer
Social and Preventive Medicine, the Middlesex Hospital
The toxic effects of mercury are dependent on the compound to which exposure occurs and on the route of absorption. The kidney retains more mercury than any other organ in the body and the metal is in part excreted in the urine, principally by transfer through the tubular epithelium. Urinary excretion of mercury correlates with atmospheric concentration where group data are analysed, but there can be considerable variation between individuals with similar exposure and in one individual from day to day. Estimation of urinary mercury concentration is of limited value in the diagnosis of mercurialism, as high excretion rates may be seen without clinical disorder, or mercurialism may be present when urinary excretion is low. Inorganic mercury compounds and a variety of organic mercurials have a pronounced diuretic effect in pharmacological dosage.
Larger amounts of ingested inorganic mercury salts give rise to acute tubular necrosis which may result in oliguria or anuria. The prevalence of proteinuria is increased in workers exposed to mercury vapour, inorganic mercury and certain organic mercury compounds, an effect which appears to be related to glomerular damage. In some subjects the loss of protein through the glomerulus can be of such degree that the nephrotic syndrome may result. Indirect evidence suggests that an immunological mechanism may be involved. All workers exposed to mercury or its compounds should be screened regularly for proteinuria and removed from further exposure should this develop.”http://occmed.oxfordjournals.org/cgi/content/abstract/20/2/54