Mercury-associated nephrotic syndrome: a case report and systematic review of the literature

Am J Kidney Dis. 2013 Jul;62(1):135-8. doi: 10.1053/j.ajkd.2013.02.372. Epub 2013 Apr 18.


Kidney injury from mercury is known to cause dose-related tubular dysfunction and idiosyncratic nephrotic syndrome according to various case reports. Motivated by a patient with subacute-onset nephrotic syndrome, histologic features of secondary focal segmental glomerulosclerosis, and concurrent mercury toxicity, we conducted a systematic review to explore renal histologic changes in patients with toxic mercury exposures and nephrotic syndrome. Data were extracted from a patient's clinical record. MEDLINE/Ovid was searched from 1950 to November 2010 using a prespecified search strategy. Two nephrology textbooks and the UpToDate online database also were searched. Inclusion criteria were studies of humans with nephrotic syndrome, nephrotic-range proteinuria, or kidney biopsy results reported. There were no exclusion criteria. We identified 27 other reports of 42 patients with nephrotic syndrome or nephrotic-range proteinuria. Of the 26 individuals, including our patient, who underwent kidney biopsy, histology showed glomerular disease in 21. Of these 20 biopsies, 4 showed minimal change disease and 15 showed membranous glomerulonephritis. Mercury exposure can lead to various glomerular lesions; we emphasize the importance of a careful occupational and dietary history in elucidating a cause for the undetermined nephrotic syndrome.

Publication types

  • Case Reports
  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Environmental Exposure / adverse effects
  • Fishes
  • Fresh Water
  • Humans
  • Male
  • Mercury / administration & dosage
  • Mercury / urine*
  • Middle Aged
  • Nephrotic Syndrome / diagnosis*
  • Nephrotic Syndrome / urine*


  • Mercury