TABLE 3-1 Selected Biomarkers or Biochemical Indicators of Renal Effects of Exposure to Uranium

Indicators of tubular toxicity

Increased excretion of low-molecular-weight proteins in urine:

  • β2 microglobulin (β2m)

  • retinol-binding protein (RBP)

  • other low-molecular-weight substances

  • amino acids and glucose

 

Increased concentrations of enzymes in urine (enzymuria):

  • alkaline phosphatase (ALP)

  • aspartate aminopeptidase (ASP)

  • catalase

  • gamma-glutamyltransferease (GGT)

  • lactate dehydrogenase (LDH)

  • leucine aminopeptidase (LAP)

  • N-acetyl glucosaminidase (NAG)

Indicators of glomerular toxicity

Increased excretion of large-molecular-weight proteins in urine:

  • proteinuria

  • albuminuria

  • minialbuminuria

Indicators of renal failure

Increased serum concentrations of:

  • nonprotein nitrogen (NPN)

  • creatinine

  • urea

Sources: Nomiyama and Foulkes 1968; Nomiyama et al. 1974; Wedeen et al. 1998.

glucosuria in diabetes mellitus, which is due to blood glucose concentrations that are above the normal threshold for reabsorption. Uranium exposure may also produce glomerular injury that results in leakage of albumin and other high-molecular-weight proteins. Renal failure is characterized by inability to excrete metabolic wastes and is reflected by increases in nonprotein nitrogen (NPN), urea, or creatinine in blood or serum.

HUMAN STUDIES

Acute Exposure

Few reports have documented episodes of acute human exposure to uranium compounds. Table 3-2 is a compilation of data cited by the Royal Society (2002) and in the Capstone Report (Guilmette et al. 2005; Parkhurst et al. 2005) as modified here after committee review. The episodes varied in form of uranium and route of exposure. They include exposure to uranium hexafluoride,



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