Contact with many drugs and chemicals can produce glomerular injury. A common sign of such injury is proteinuria. Chemicals and drugs act through diverse mechanisms to produce injury, including direct damage to cellular and membranous glomerular components, as well as to renal vasculature. Several basic pathophysiologic mechanisms, including the “intact nephron hypothesis” and the “hyperfiltration hypothesis,” help to explain the mode of toxicity of many chemicals. Furthermore, they provide a means to understand the basis for renal damage and the progression of renal disease once injury has occurred.
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