High Chromium Levels in Urine: What You Need to Know After Kidney Surgery

Excessive chromium levels in urine?

Last year, due to an adrenal tumor, I had my left kidney removed and underwent chemotherapy four times.
I am currently taking the immunotherapy drug Endoxan (Cyclophosphamide).
Because of my job, I am exposed to potassium dichromate; in the dairy factory, we use potassium dichromate as an indicator to test for chloride ions during the raw milk inspection.
Therefore, my health check included a urine chromium test.
In August of last year, the result was 0.5 µg/g CRE, so my company asked me to retest on December 1st, and the result was still above the standard.
Today, I consulted my oncologist, who said that this is not caused by the chemotherapy drugs.
I would like to know which specialty I should see for regular check-ups: nephrology or family medicine?

Yuan, 40~49 year old female. Ask Date: 2023/01/04

Dr. Li Jian reply Internal Medicine

It is advisable to consult a toxicologist, as you may need to go to a medical center that has a toxicology department.

Reply Date: 2023/01/04

More Info

High chromium levels in urine can be a significant concern, especially for individuals with a history of kidney surgery and exposure to chromium compounds in their work environment. Given your situation, where you have undergone left kidney removal due to an adrenal tumor and are currently undergoing chemotherapy with Endoxan (cyclophosphamide), it is essential to understand the implications of elevated chromium levels and the appropriate follow-up care.

Chromium is a trace element that plays a role in glucose metabolism and insulin sensitivity. However, excessive exposure to chromium, particularly hexavalent chromium, can lead to various health issues, including kidney damage. In your case, the elevated chromium levels in urine (0.5 µg/g creatinine) indicate a potential overload of this metal in your system, which could be exacerbated by your occupational exposure to potassium dichromate, a known carcinogen.

1. Understanding Chromium Levels: The normal range for chromium in urine can vary, but elevated levels can indicate excessive exposure or impaired renal function. Since you have already had kidney surgery, your remaining kidney may be under additional stress, which could affect its ability to filter out toxins, including chromium.

2. Follow-Up Care: Given your history and the elevated chromium levels, it is advisable to consult with a nephrologist (kidney specialist). They can perform a thorough evaluation of your kidney function, including blood tests (like serum creatinine and estimated glomerular filtration rate) and possibly imaging studies to assess the health of your remaining kidney. They will also be able to determine if the chromium levels are affecting your renal function or if they are a result of your occupational exposure.

3. Occupational Health Considerations: Since your work involves exposure to chromium, it may also be beneficial to consult with an occupational health specialist. They can provide guidance on minimizing exposure and monitoring for potential health effects related to chromium exposure. This is particularly important given your medical history and the potential for cumulative effects from both occupational exposure and chemotherapy.

4. Monitoring and Management: Regular monitoring of your kidney function and chromium levels will be crucial. Your nephrologist may recommend periodic urine tests to track chromium levels and assess any changes in kidney function. If necessary, they may also suggest dietary modifications or medications to support kidney health and reduce chromium absorption.

5. Chemotherapy Considerations: While your oncologist has indicated that the elevated chromium levels are not due to the chemotherapy drugs, it is essential to keep all your healthcare providers informed about your occupational exposure and any symptoms you may experience. This collaborative approach will ensure comprehensive care and monitoring.

In summary, it is advisable to follow up with a nephrologist for further evaluation of your kidney function and chromium levels. Additionally, consulting with an occupational health specialist can help address any concerns related to your work exposure. Regular monitoring and a proactive approach to managing your health will be essential in navigating the complexities of your medical history and current situation.

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