Associations of blood lead with estimated glomerular filtration rate using MDRD, CKD-EPI and serum cystatin C-based equations

Details

• Personal Author:
  Fadrowski J ; Guallar E ; Jaar B ; Navas-Acien A ; Spector JT ; Weaver VM
• Description:
  BACKGROUND: Low-level lead exposure is widespread and has been implicated as a chronic kidney disease (CKD) risk factor. However, studies evaluating associations of lead dose with newer, potentially more accurate, estimates of kidney function, in participants with a wide range of glomerular filtration rates (GFRs), are scarce. METHODS: We compared associations of blood lead and estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and cystatin C single variable, multivariable and combined creatinine/cystatin C equations in 3941 adults who participated in the 1999-2002 National Health and Nutrition Examination Survey cystatin C subsample. RESULTS: Geometric mean blood lead was 1.7 µg/dL. After multivariable adjustment, differences [95% confidence interval (CI)] in mean eGFR for a doubling of blood lead were -1.9 (-3.2, -0.7), -1.7 (-3.0, -0.5) and -1.4 (-2.3, -0.5) mL/min/1.73 m(2), using the cystatin C single variable, multivariable and combined creatinine/cystatin C equations, respectively, reflecting lower eGFR with increased blood lead. The corresponding differences (95% CI) were -0.9 (-1.9, 0.02) and -0.9 (-1.8, 0.01) using the creatinine-based MDRD and CKD-EPI equations, respectively. In participants aged =60 years, differences in mean eGFR ranged from -3.0 to -4.5 mL/min/1.73 m(2), and odds of reduced eGFR (<60 mL/min/1.73 m(2)) were increased for all estimates of GFR. CONCLUSIONS: These results support the inclusion of cystatin C-based eGFR in future lead research and provide additional evidence for environmental lead exposure as a CKD risk factor. [Description provided by NIOSH]
• Subjects:
  Blood Chronic Disease Hematologic Tests Occupational Health Safety
• Keywords:
  Author Keywords: Blood Lead Blood Analysis Blood Lead Levels Chronic Diseases Kidney Function Kidneys Lead Exposure NHANES
• ISSN:
  0931-0509
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 10 ; OSHA Region 3 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  26
• Issue:
  9
• NIOSHTIC Number:
  nn:20040228
• Citation:
  Nephrol Dial Transplant 2011 Sep; 26(9):2786-2792
• Email:
  vweaver@jhsph.edu
• CAS Registry Number:
  Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2011
• Performing Organization:
  Johns Hopkins University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Nephrology Dialysis Transplantation
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:434972c8468a61e1f98b10f511eb4587de8e9e0ff91195a2546df1136a591f097750ffaaf1b093b0e09c209afdcc295d68f5a85c91e577b53778e7754780e4b8
• Download URL:
  https://stacks.cdc.gov/view/cdc/193170/cdc_193170_DS1.pdf
• File Type:
  [PDF - 132.04 KB ]