Uranium Associations with Kidney Outcomes Vary by Urine Concentration Adjustment Method

Details

• Alternative Title:
  J Expo Sci Environ Epidemiol
• Personal Author:
  Shelley, Rebecca ; Kim, Nam-Soo ; Parsons, Patrick J. ; Lee, Byung-Kook ; Agnew, Jacqueline ; Jaar, Bernard G. ; Steuerwald, Amy J. ; Matanoski, Genevieve ; Fadrowski, Jeffrey ; Schwartz, Brian S. ; Todd, Andrew C. ; Simon, David ; Weaver, Virginia M.
• Description:
  Uranium is a ubiquitous metal that is nephrotoxic at high doses. Few epidemiologic studies have examined the kidney filtration impact of chronic environmental exposure. In 684 lead workers environmentally exposed to uranium, multiple linear regression was used to examine associations of uranium measured in a 4-h urine collection with measured creatinine clearance, serum creatinine- and cystatin-C-based estimated glomerular filtration rates, and N-acetyl-β-D-glucosaminidase (NAG). Three methods were utilized, in separate models, to adjust uranium levels for urine concentration--μg uranium/g creatinine; μg uranium/l and urine creatinine as separate covariates; and μg uranium/4 h. Median urine uranium levels were 0.07 μg/g creatinine and 0.02 μg/4 h and were highly correlated (rs=0.95). After adjustment, higher ln-urine uranium was associated with lower measured creatinine clearance and higher NAG in models that used urine creatinine to adjust for urine concentration but not in models that used total uranium excreted (μg/4 h). These results suggest that, in some instances, associations between urine toxicants and kidney outcomes may be statistical, due to the use of urine creatinine in both exposure and outcome metrics, rather than nephrotoxic. These findings support consideration of non-creatinine-based methods of adjustment for urine concentration in nephrotoxicant research.
• Subjects:
  Adult Article Creatinine Female Glomerular Filtration Rate Humans Kidney Function Lead Male Metallurgy Metals Middle Aged Occupational Exposure Tibia Uranium

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• Source:
  J Expo Sci Environ Epidemiol. 24(1):58-64.
• Pubmed ID:
  23591699
• Pubmed Central ID:
  PMC5457699
• Document Type:
  Journal Article
• Funding:
  R01 ES007198/ES/NIEHS NIH HHS/United States ; T42 OH008428/OH/NIOSH CDC HHS/United States ; 2 ES007198/ES/NIEHS NIH HHS/United States ; T42 OH0008428/OH/NIOSH CDC HHS/United States
• Volume:
  24
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ab30346ac4f98a40f644e0ab3a37126cc4c5531db190dd82fea08ef639bb7dd4
• Download URL:
  https://stacks.cdc.gov/view/cdc/45954/cdc_45954_DS1.pdf
• File Type:
  [PDF - 345.83 KB ]