Subclinical Changes in Urinary Protein Excretion of Renal Cell Cancer
Patients: Effect of High Occupational Exposure to Trichloroethylene*
Klaus Golka1, Tekla Hartert-Raulf2, Wolfgang Schöps2,
Gerd Kierfeld2, Thomas Brüning1 and Hermann
M. Bolt1
1Institute of Occupational Physiology at the University of Dortmund,
Dortmund, Germany
2 Department of Urology, Leverkusen Hospital, Leverkusen,
Germany
Corresponding author: Prof. Dr. Dr. H. M. Bolt
Institut für Arbeitsphysiologie an der Universität
Dortmund, Ardeystr. 67,
D-44139 Dortmund, Germany
Tel: + 49 - 231 - 1084348
Fax:+ 49 - 231 - 1084403
E-mail: bolt@arb-phys.uni-dortmund.de
*The authors thank the Bundesminister für
Arbeit und Sozialordnung of the Federal Republic of Germany (Zentrum Arbeit
und Gesundheit Dortmund/Wuppertal) for providing financial support which
made these studies possible.
CEJOEM 1997, 3:167-174
Key words:
Renal cell cancer, proteinuria, trichloroethylene, nephrectomy
Abstract:
The prevalence of subclinical renal damage in unilaterally nephrectomized
patients was evaluated by detecting urinary protein excretions using SDS-PAGE
which separates proteins according to their molecular size. In 17 patients
with a long-term history of high exposure to the solvent trichloroethylene
and having recieved nephrectomy because of development of renal cell cancer,
no case with normal urinary protein patterns was observed; instead, 14
of these were diagnosed with tubular damage and 3 with mixed glomerular
and tubular damage. By contrast, among 40 patients after operative renal
cell cancer treatment, but without a history of occupational trichloroethylene
exposure, 14 displayed normal uninary protein excretion patterns. In addition,
when the urinary protein excretions of renal cell cancer patients were
evaluated before, 5 days and 4 months after unilateral nephrectomy, an
influence of the operative treatment on the protein excretion by the remaining
kidney was noted pointing to a limited incidence of subclinical tubular
damage, the most likely explanation being “hyperfiltration” in response
to loss of renal mass.
The results seen in renal cell cancer patients with
and without a specific history of occupational trichloroethylene exposure
are consistent with the view that chronic tubular damage could be regarded
as a prerequisite for induction of human renal cell cancer by trichloroethylene.
This is in line with recent findings of human nephrocarcinogenicity of
trichloroethylene.
Received: 21 July 1997
Accepted: 11 August 1997
Posted: 25 November 1998 |
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