Comparison of Ultrastructural Features Between Patients with Mercury-associated Membranous Nephropathy and Idiopathic Membranous Nephropathy

The Relationship Between Mercury Exposure and Membranous Nephropathy: Case Reports and Meta-Analysis

To investigate the clinical characteristics of patients with membranous nephropathy (MN) and the therapeutic efficacy of Sodium Dimercaptosulphonate (DMPS), as well as the relationship between mercury (Hg) exposure and MN, we investigated the clinical manifestations and treatment outcomes of six patients with MN and searched the China National Knowledge Internet (CNKI), PubMed, Web Of Science, and Embase databases for relevant studies on Hg exposure and MN published from the inception of the databases to April 2024. Data analysis was performed using SPSS 26.0 and Stata 16.0. We found that (1) the clinical symptoms of MN patients were mainly characterized by proteinuria, edema, hypoproteinemia, and hyperlipidemia. Comparative analysis before and after DMPS treatment showed a decrease in 24-h urinary Hg, 24-h urinary protein, and total cholesterol levels, as well as an increase in serum albumin levels (p < 0.05). (2) Two MN patients received DMPS for sole Hg detoxification treatment, whereas four patients received Hg detoxification combined with hormone therapy, and all patients showed significant improvement in symptoms after treatment. (3) Among the 564 articles, four met the inclusion criteria. The results showed that Hg exposure increased the incidence of MN by 5.74 times (95% confidence interval [CI] = 2.57, 12.83). The clinical symptoms of MN patients are mostly manifested as proteinuria, edema, hypoproteinemia, and hyperlipidemia. DMPS Hg detoxification treatment is effective for Hg-induced MN. Hg exposure can increase the prevalence of MN, therefore making it necessary to take prudent measures to reduce the risk of Hg exposure.

Snow White's tale in nephrology: the emerging threat of skin-whitening creams on kidney health

The timeless tale of Snow White, with its emphasis on fair skin as a beauty ideal, mirrors a contemporary issue in nephrology: the harmful impact of skin-whitening creams on kidney health. Fairness creams have deeply embedded themselves in global society, driven by a pervasive obsession with lighter skin tones as a symbol of beauty. This widespread use reflects deeply rooted cultural beliefs and social norms, despite the significant health risks associated with these products. Despite regulatory bans, these creams often contain hazardous substances such as hydroquinone, mercury, and arsenic, posing serious health risks. Mercury, a frequent component of these cosmetics, disrupts melanin synthesis by inhibiting tyrosinase, leading to serious health risks, including nephrotoxicity. Chronic exposure to mercury from cosmetics can harm the liver, kidneys, nervous system, and eyes, with the kidneys being particularly vulnerable. This review discusses the link between fairness creams and the occurrence of glomerular diseases. It delves into the mechanisms by which skin-whitening agents cause kidney damage. Mercury can induce kidney damage through direct cellular toxicity and immune-mediated mechanisms. We present evidence from case studies and published studies connecting mercury-containing creams to nephrotic syndrome. Minimal change disease and membranous nephropathy are the most frequently reported glomerular diseases due to these products. Treatment typically involves stopping the use of the creams and chelation therapy, with glucocorticoids and immunosuppressants for non-responsive cases. The prognosis is generally favourable, with high remission rates, and relapses are seldom reported. By highlighting the nephrotoxic effects of skin-whitening creams, this manuscript emphasizes the urgent need for stringent regulatory oversight and increased public awareness to prevent further health complications.

Molecular Mechanisms of Cellular Injury and Role of Toxic Heavy Metals in Chronic Kidney Disease

Chronic kidney disease (CKD) is a progressive disease that affects millions of adults every year. Major risk factors include diabetes, hypertension, and obesity, which affect millions of adults worldwide. CKD is characterized by cellular injury followed by permanent loss of functional nephrons. As injured cells die and nephrons become sclerotic, remaining healthy nephrons attempt to compensate by undergoing various structural, molecular, and functional changes. While these changes are designed to maintain appropriate renal function, they may lead to additional cellular injury and progression of disease. As CKD progresses and filtration decreases, the ability to eliminate metabolic wastes and environmental toxicants declines. The inability to eliminate environmental toxicants such as arsenic, cadmium, and mercury may contribute to cellular injury and enhance the progression of CKD. The present review describes major molecular alterations that contribute to the pathogenesis of CKD and the effects of arsenic, cadmium, and mercury on the progression of CKD.