Evidence of Nickel and Other Trace Elements and Their Relationship to Clinical Findings in Acute Mesoamerican Nephropathy: A Case-Control Analysis

Details

• Personal Author:
  Fischer RSB ; Mandayam S ; Murray KO ; Sanderson, Wayne T. ; Unrine JM ; Vangala C
• Description:
  Background: Although there are several hypothesized etiologies of Mesoamerican Nephropathy (MeN), evidence has not yet pointed to the underlying cause. Exposure to various trace elements can cause the clinical features observed in MeN. Methods and findings: We measured 15 trace elements, including heavy metals, in renal case-patients (n = 18) and healthy controls (n = 36) in a MeN high-risk region of Nicaragua. Toenails clippings from study participants were analyzed using inductively coupled plasma mass spectrometry. A case-control analysis was performed, and concentrations were also analyzed over participant characteristics and clinical parameters. Nickel (Ni) concentrations were significantly higher in toenails from cases (1.554 mg/kg [0.176-42.647]) than controls (0.208 mg/kg [0.055-51.235]; p<0.001). Ni concentrations correlated positively with serum creatinine levels (p = 0.001) and negatively with eGFR (p = 0.001). Greater Ni exposure was also associated with higher leukocyte (p = 0.001) and neutrophil (p = 0.003) counts, fewer lymphocytes (p = 0.003), and lower hemoglobin (p = 0.004) and hematocrit (p = 0.011). Conclusions: Low-dose, chronic environmental exposure to Ni is a possible health risk in this setting. Ni intoxication and resulting systemic and renal effects could explain the clinical signs observed during early MeN. This study provides compelling evidence for a role of Ni in the acute renal impairment observed in this MeN high-risk population. Additional work to assess exposure levels in a larger and heterogeneous population, identify environmental sources of Ni and exposure pathways, and evaluate the link between Ni and MeN pathogenesis are urgently needed. [Description provided by NIOSH]
• Subjects:
  Environmental Exposure Nickel Occupational Health Safety
• Keywords:
  Environmental Exposure Kidney Disorders Nephrological Disorders Trace Substances
• ISSN:
  1932-6203
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Kentucky ; Maryland ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  15
• Issue:
  11
• NIOSHTIC Number:
  nn:20067475
• Citation:
  PLoS One 2020 Nov; 16(11):e0240988
• Contact Point Address:
  Rebecca S. B. Fischer, Section of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States of America
• Email:
  kmurray@bcm.edu
• CAS Registry Number:
  Nickel (CAS RN 7440-02-0)
• Federal Fiscal Year:
  2021
• Performing Organization:
  University of Kentucky, Lexington
• Peer Reviewed:
  True
• Start Date:
  20120701
• Source Full Name:
  PLoS One
• End Date:
  20240630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:29e7d71ba9f43e117a484f89cc23ec1e2ec8ff164918c01a23f0ba63047fb96a1f91bc897ec1507abae27362d1723f0b38e0b9233086ec329e62509b30d2d65b
• Download URL:
  https://stacks.cdc.gov/view/cdc/231469/cdc_231469_DS1.pdf
• File Type:
  [PDF - 1.50 MB ]