Chronic kidney disease: Stemming the global tide

Nwankwo, Emeka; Bello, Aminu K.; Nahas, A. Meguid El

doi:10.1053/j.ajkd.2004.09.005

Cited by 25 publications

(19 citation statements)

References 45 publications

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“…Approximately 11.5% of US adults have CKD [Levey et al, ], and its prevalence is increasing in the US [Coresh et al, ] and in many other countries [Bello et al, ; Nwankwo et al, ]. Overall Medicare expenditures for CKD reached $41 billion in 2010 according to the US Renal Data System [US Renal Data System, ].…”

Section: Introductionmentioning

confidence: 99%

Occupational exposures and chronic kidney disease: Possible associations with endotoxin and ultrafine particles

Sponholtz

Sandler

Parks

et al. 2015

American J Industrial Med

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Background Chronic kidney disease (CKD) carries a high public health burden yet there is limited research on occupational factors, which are examined in this retrospective case-control study. Methods Newly diagnosed cases of CKD (n=547) and controls (n=508) from North Carolina provided detailed work histories in telephone interviews. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results There was heterogeneity in the association of CKD and agricultural work, with crop production associated with increased risk and work with livestock associated with decreased risk. Work with cutting/cooling/lubricating oils was associated with a reduced risk. CKD risk was increased for working in dusty conditions. Conclusions CKD risk was reduced in subjects with occupational exposures previously reported to involve endotoxin exposure. Further, exposure to dusty conditions was consistently associated with increased risk of glomerulonephritis across industry, suggesting that research on CKD and ultrafine particulates is needed.

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Section: Introductionmentioning

confidence: 99%

Occupational exposures and chronic kidney disease: Possible associations with endotoxin and ultrafine particles

Sponholtz

Sandler

Parks

et al. 2015

American J Industrial Med

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“…Finally, it is recommended that evaluation of environmental and occupational nephrotoxins like lead be incorporated into programs for the prevention of CKD, especially in developing countries where lead exposure and toxicity still remain largely unchecked 2,7-9 and the prevalence and burden of CKD is increasing. 9,112 …”

Section: Discussionmentioning

confidence: 98%

Lead Nephropathy: Revisiting an Overlooked Cause of Kidney Disease

Alasia

2010

Nephrology Research & Reviews

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Despite the recognition of lead nephropathy as a consequence of environmental and occupational lead exposure, lead nephropathy still appears to be underrecognized by physicians as a cause and promoter of chronic kidney disease (CKD), especially in people with more apparent causative factors such as diabetes and hypertension. This review focuses on the clinical, pathophysiological and epidemiological perspectives of lead nephropathy with the objective of promoting the awareness of this important but overlooked cause of CKD among physicians. Literature was reviewed using available medical journals and online literature search through Google, Pubmed, Medline, Medscape and HINARI databases. The key words employed were: Lead Nephropathy, Environmental and Occupational lead exposure and chronic kidney disease. Lead nephropathy which is a tubulointerstitial nephritis, may present acutely or chronically in association with hypertension. The clinical diagnosis of lead nephropathy is complex, because the symptoms are varied and non-specific especially with subclinical nephrotoxicity. The recognition of lead nephropathy can be enhanced if physicians have a high index of suspicion in the assessment of patients with renal disease. It is recommended that the evaluation of environmental and occupational nephrotoxins like lead be incorporated into programs for the prevention of CKD, especially in developing countries where lead exposure and toxicity still remain largely unchecked and the prevalence and burden of CKD is increasing

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“…15 Lead which is an environmental and occupational nephrotoxin should be evaluated in programs for the prevention of CKD, especially in developing countries where lead exposure still remain largely unchecked and the prevalence and burden of CKD is increasing. 16,17 Chelation therapy (DMSA/Calcium EDTA) can be considered for individuals with blood lead levels 4100 mcg/dL, and should also be considered for levels between 80 to 100 mcg/dL in asymptomatic individuals and for blood lead levels between 50 to 80 mcg/dL in individuals with lead- related symptoms. 18 Chelation should be considered when exposure has been definitively curtailed, because its use in the presence of continuing exposure may result in enhanced absorption of lead and worsening, rather than amelioration of toxicity/kidney injury.…”

Section: Discussionmentioning

confidence: 99%

Lead nephropathy due to Sindoor in India

et al. 2013

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We report a case of lead nephropathy due to Sindoor treated successfully with steroid, hemodialysis and chelating agent. Diagnosis of lead nephropathy was confirmed by identification of potential sources of lead exposure (Sindoor, 5-10 gm per year for 11 years) indicated by high blood lead level, 95 mg/dL and presence of extrarenal features of lead poisoning (hypertension, anemia, lead line, hyperuricemia). A search for the underlying systemic causes of renal failure yielded no results. A kidney biopsy showed acute or chronic tubule-interstitial nephritis with mesangioproliferative glomerulonephritis with no immune deposit on immunofluorescence consistent with lead nephropathy. He was discharged in good health after psychiatric consultation and continued with oral D-Penicillamine with normal renal function tests and urine output. This case identifies Sindoor as a potential lead exposure among Indians and clinicians should be aware of this risk factor and enquire about it when searching a source of lead exposure in high-risk population.

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Chronic kidney disease: Stemming the global tide

Cited by 25 publications

References 45 publications

Occupational exposures and chronic kidney disease: Possible associations with endotoxin and ultrafine particles

Occupational exposures and chronic kidney disease: Possible associations with endotoxin and ultrafine particles

Lead Nephropathy: Revisiting an Overlooked Cause of Kidney Disease

Lead nephropathy due to Sindoor in India

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