Lead Nephropathy - A Preventable Cause of Renal Failure

Pollock, Carol; Ibels, L. S.

doi:10.1177/039139888801100204

Cited by 17 publications

(13 citation statements)

References 26 publications

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“…Children are more susceptible to the effects of environmental lead than adults because of increased gastrointestinal absorption of lead in children (21). Adults at highest risk are those exposed to lead fumes or dust in industry (22,23).…”

Section: Environmental Lead Exposurementioning

confidence: 99%

Renal Effects of Environmental and Occupational Lead Exposure

Loghman‐Adham¹

1997

Environmental Health Perspectives

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Section: Environmental Lead Exposurementioning

confidence: 99%

Renal Effects of Environmental and Occupational Lead Exposure

Loghman‐Adham¹

1997

Environmental Health Perspectives

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“…However, the BLL reflects recent lead exposure rather than the actual body lead burden (BLB). Calcium disodium EDTA mobilization tests and bone x-ray fluorescence studies are the most reliable methods for measuring the BLB (7). A BLB of Ͼ600 g (2.9 mol), as assessed by calcium disodium EDTA mobilization tests, indicates lead poisoning.…”

mentioning

confidence: 99%

Environmental Exposure to Lead and Progression of Chronic Renal Diseases

Lin²,

Lin-Tan³

2004

Journal of the American Society of Nephrology

116

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Abstract. Previous retrospective research suggests that lowlevel environmental lead exposure is associated with an acceleration of age-related impairment of renal function. For elucidating the long-term relationship between low-level environmental lead exposure and progression of chronic renal diseases in patients without diabetes, 121 patients who had chronic renal insufficiency, a normal body lead burden (BLB), and no history of exposure to lead were observed prospectively for 48 mo. Associations of both BLB and blood lead level (BLL) with renal function were evaluated, with reference to other covariates. The primary end point was an increase in the serum creatinine level to double the baseline value. Sixty-three patients had BLB Ն80 g and Ͻ600 g (high-normal group), and 58 patients had BLB Ͻ80 g (low-normal group). The primary end point occurred in 17 patients. Fifteen of them had high-normal BLB, whereas two patients had low-normal BLB (hazard ratio [95% confidence interval]: 1.01 [1.00 to 1.01] for each increment of 1 g; P ϭ 0.002). The BLB and BLL at baseline were the most important risk factors to predict progression of renal insufficiency. Each increase of 10 g in the BLB or 1 g/dl in the BLL reduced the GFR by 1.3 (P ϭ 0.002) or 4.0 ml/min (P ϭ 0.01) during the study period. In conclusion, low-level environmental lead exposure is associated with accelerated deterioration of renal insufficiency. Even at levels far below the normal ranges, both increased BLL and BLB predict accelerated progression of chronic renal diseases.A high occupational lead exposure is well documented to be able to induce nephropathy (1,2). Several studies have indicated a strong association between blood lead levels (BLL) and agerelated decline in renal function of the general population (3-6). However, these studies either were retrospective or did not adjust other confounding factors that affect the progression of renal function, such as hypertension, urinary protein excretion, and usage of angiotensin-converting enzyme (ACE) inhibitors.Furthermore, most of these studies measured BLL as an indicator of lead exposure. However, the BLL reflects recent lead exposure rather than the actual body lead burden (BLB). Calcium disodium EDTA mobilization tests and bone x-ray fluorescence studies are the most reliable methods for measuring the BLB (7). A BLB of Ͼ600 g (2.9 mol), as assessed by calcium disodium EDTA mobilization tests, indicates lead poisoning. The authors' previous studies, using EDTA-mobilization tests to assess the BLB, suggested that low-level environmental lead exposure may be associated with the progression of renal insufficiency in patients without known lead exposure (8 -10). Our recent work further established that repeated chelation therapy to reduce the BLB may slow the progression of renal insufficiency in a 27-mo clinical trial (11). However, the long-term relationship between low-level environmental lead exposure and the progression of chronic renal diseases remains unknown. A 48-mo prospective longitudinal stu...

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“…This is because blood lead levels only reflect recent exposure to lead (7) and not the lead burden of the body. According to recent reports, body lead burden can be measured by collecting 72-hour urinary lead excretion after intravenous infusion of 1 g of CaNa 2 EDTA.…”

Section: Introductionmentioning

confidence: 99%

Do people from Taiwan have higher heavy metal levels than those from Western countries?

Liu¹,

Hung

Huang³

et al. 2017

smedj

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INTRODUCTIONSeveral studies have suggested that blood lead and cadmium levels that are well below the current safety standards are associated with health risks, such as peripheral arterial disease, impaired renal function and elevated blood pressure.(1-3) Menke et al reported that blood lead level was significantly associated with myocardial infarction and stroke mortality, even when it was below 0.48 μmol/L (10 μg/dL).(4) A Taiwanese study by Huang reported that seafood contamination was very common in Taiwan, and that the lead and copper levels of the rivers in Taiwan were the highest in the world.(5) The abstract of a study that investigated the concentration of heavy metals in the hair of 700 residents in Taiwan reported that most of the residents exhibited elevated heavy metal levels.(6) However, this abstract is unpublished and only found on the Internet.(6) To the best of our knowledge, there has been no formal report describing the heavy metal levels of healthy subjects in Taiwan. The two reports (5,6) indicate that the finding of elevated heavy metal levels in Taiwanese people might not be unusual. Therefore, for the present study, we hypothesised that there may be greater levels of four common heavy metals (lead, mercury, arsenic and cadmium) in the blood of a Southern Taiwanese population than in Western populations.The most reliable methods for measuring body lead burden are bone X-ray fluorescence studies and calcium disodium ethylenediaminetetraacetic acid (CaNa 2 EDTA) mobilisation tests. This is because blood lead levels only reflect recent exposure to lead (7) and not the lead burden of the body. According to recent reports, body lead burden can be measured by collecting 72-hour urinary lead excretion after intravenous infusion of 1 g of CaNa 2 EDTA.(8,9) These reports recommend the daily collection of urine for 72 hours in a high-volume container before the urine is sent for lead measurement. If most of the lead (or other heavy metal) can be excreted during the first 24 hours after CaNa 2 EDTA infusion, then the level of heavy metal in the urine during the first 24 hours may be reflective of the body burden of these heavy metals. We hypothesised that the level of heavy metal in the urine collected in the first 24 hours would be positively correlated with the body burden of the heavy metal. Thus, the aim of the present study was twofold. First, we aimed to assess the levels of four common heavy metals (lead, mercury, arsenic and cadmium) in the blood of apparently healthy Taiwanese adults and to determine whether these heavy metal levels are greater than those of adults from Western countries. Second, we aimed to test our hypothesis that the level of heavy metal in first-day urine is reflective of the body burden of heavy metals (i.e. most heavy metals are excreted during the first 24 hours). METHODSA total of 40 apparently healthy persons (34 men, six women)

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Lead Nephropathy - A Preventable Cause of Renal Failure

Cited by 17 publications

References 26 publications

Renal Effects of Environmental and Occupational Lead Exposure

Renal Effects of Environmental and Occupational Lead Exposure

Environmental Exposure to Lead and Progression of Chronic Renal Diseases

Do people from Taiwan have higher heavy metal levels than those from Western countries?

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