Eldad et al studied the systemic effects of phosphorus poisoning in white rats. Renal toxicity can lead to acute renal failure, which may be part of multi-organ failure. The authors are from Hadassah University Hospital in Jerusalem and the Israel Defense Force Medical Corps.
NOTE: Although described in white rats, the histologic changes would be the same in a human exposed to phosphorus.
Parameters:
(1) hemorrhage
(2) glomerular damage
(3) hyaline membrane formation
(4) damage to the renal tubules
(5) damage to the renal papillae
|
Parameter |
Finding |
Points |
|
hemorrhage |
none |
2 |
|
|
glomeruli only |
1 |
|
|
severe and diffuse |
0 |
|
glomerular damage |
none, normal |
2 |
|
|
mild and focal |
1 |
|
|
diffuse and severe, with prominent necrosis |
0 |
|
hyaline membranes |
absent |
2 |
|
|
thin, short, focal, patchy |
1 |
|
|
thick, long, widespread |
0 |
|
damage to renal tubules |
none |
2 |
|
|
partial, mild and focal |
1 |
|
|
severe and extensive damage |
0 |
|
damage to renal papillae |
none, normal |
2 |
|
|
inflammation present |
1 |
|
|
necrosis present |
0 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The lower the score the more severe the nephrotoxicity.
Specialty: Toxicology, Emergency Medicine, Critical Care
