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Title: | Two-Year Responses of Renal Function to First Occupational Lead Exposure | Authors: | Yu, Yu-Ling Thijs, Lutgarde Wei, Dong-Mei Melgarejo, Jesus D. Yu, Cai-Guo Yang, Wen-Yi ROELS, Harry Zhang , Zhen-Yu NAWROT, Tim Staessen, Jan A. |
Issue Date: | 2022 | Publisher: | ELSEVIER SCIENCE INC | Source: | Kidney international reports, 7 (6) , p. 1198 -1209 | Abstract: | Introduction: Whether in advanced countries lead exposure still contributes to renal impairment is debated, because blood lead (BL) level is declining toward preindustrial levels and because longitudinal studies correlating renal function and BL changes over time are scarce. Methods: The Study for Promotion of Health in Recycling Lead (SPHERL) evaluated the 2-year renal function responses in 251 workers (mean age, 29.7 years) transiting from environmental to occupational exposure. Main study end point was the estimated glomerular filtration rate (eGFR) derived from serum creatinine (eGFRcrt), cystatin C (eGFRcys), or both (eGFRcc). BL level was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 mu g/dl). Results: In the follow-up, mean baseline BL level of 4.13 mu g/dl increased 3.30-fold. In fully adjusted mixed models, additionally accounting for the within-participant clustering of the 1- and 2-year follow-up data, a 3-fold BL level increment was not significantly correlated with changes in eGFR with estimates amounting to -0.86 (95% CI: -2.39 to 0.67), -1.58 (-3.34 to 0.18), and -1.32 (-2.66 to 0.03) ml/min per 1.73 m2 for eGFRcrt, eGFRcys, or eGFRcc, respectively. Baseline BL level and the cumulative lead burden did not materially modify these estimates, but baseline eGFR was a major determinant of eGFR changes showing regression to the mean during follow-up. Responses of serum osmolarity, urinary gravity, or the urinary albumin-to-creatinine ratio (ACR) were also unrelated to the BL level increment. The age-related decreases in eGFRcrt, eGFRcys, and eGFRcc were -1.41, -0.96, and -1.10 ml/min per 1.73 m2, respectively. Conclusion: In the current study, the 2-year changes in renal function were unrelated to the increase in BL level. However, given the CIs around the point estimates of the changes in eGFRcc and eGFRcys, a larger study with longer follow-up is being planned. 2022 International Society of Nephrology. Published by Elsevier Inc. | Notes: | Staessen, JA (corresponding author), Res Inst Alliance Promot Prevent Med, Leopoldstr 59, BE-2800 Mechelen, Belgium. jan.staessen@appremed.org |
Keywords: | cystatin C;glomerular filtration rate;lead;occupational medicine;renal function | Document URI: | http://hdl.handle.net/1942/37674 | ISSN: | 2468-0249 | e-ISSN: | 2468-0249 | DOI: | 10.1016/j.ekir.2022.03.014 | ISI #: | WOS:000814821500010 | Rights: | 2022 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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Two-Year Responses of Renal Function to First Occupational Lead Exposure.pdf | Published version | 1.23 MB | Adobe PDF | View/Open |
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