The kidneys are the major route of arsenic excretion, as well as major site of conversion of pentavalent arsenic into the more toxic and less soluble trivalent arsenic. Sites of arsenic damage in the kidney include capillaries, tubules, and glomeruli [11]. In kidney, damaged proximal tubular cells lead to proteinuria and casts in the urine. Mitochondrial damage is also prominent in tubular cells. Oliguria is a common manifestation, but if acute arsenic poisoning is sufficiently severe to produce shock and dehydration, there is real risk of renal failure, although dialysis has been effective in overcoming this complication [11,24].
