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

• Published in: Journal of applied toxicology Vol. 45; no. 3; pp. 472 - 481
• Main Authors: Zhong, Jian‐Yuan, Mo, Ya‐Qi, Teng, Meng‐Jun, Peng, Jian‐Chao, Nong, Kang, Aschner, Michael, Yang, Dan‐Ling, Jiang, Yue‐Ming
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2025
• Subjects: Adult; Case reports; China; Cholesterol; Comparative analysis; Data analysis; Detoxification; Edema; Effectiveness; Environmental Exposure - adverse effects; Exposure; Female; Glomerulonephritis, Membranous - chemically induced; Glomerulonephritis, Membranous - drug therapy; Glomerulonephritis, Membranous - epidemiology; Humans; Hyperlipidemia; Male; Membranous nephropathy; Mercury; Mercury - toxicity; Mercury - urine; mercury exposure; Mercury Poisoning - drug therapy; meta‐analysis; Middle Aged; Nephropathy; Patients; Proteinuria; Risk reduction; Serum albumin; Unithiol - therapeutic use; China; membranous nephropathy; meta‐analysis; mercury exposure
• ISSN: 0260-437X; 1099-1263; 1099-1263
• DOI: 10.1002/jat.4721

ABSTRACT 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. As a widely existing heavy metal element, Hg has attracted particular attention for its toxicity and long‐term impacts on human health. Hg has a strong affinity for the kidney, making them the most susceptible target organ in Hg poisoning. In view of the limited research on the health hazards of Hg exposure to the kidney, this study aimed to delve into the relationship between Hg exposure and membranous nephropathy (MN) through a combination of case reports and meta‐analysis.