October 1985

Chelation Therapy in Lead Nephropathy Questioned

Arch Intern Med. 1985;145(10):1927. doi:10.1001/archinte.1985.00360100201040

To the Editor.  —I was concerned when I read the account in the Archives by Germain et al1 of attempted lead chelation therapy in an elderly patient with progressive renal insufficiency. Several factors that could have either explained or contributed to this condition were cited, including lead "exposure," the extent or magnitude of which was not specified.Even though the initial blood lead level was only 10 μg/dL of blood, the authors administered edetic acid (EDTA), allegedly to improve the patient's renal function. It is not clear why the authors perceived that increasing the renal lead burden would help seriously compromised kidneys. Indeed, the Occupational Safety and Health Administration, in its lead standard, condemns the administration of this agent in lead-exposed individuals under circumstances other than those in which the overriding medical concern justifies the wellknown renal risks associated with the drug's administration. Edetic acid itself is nephrotoxic, as

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