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Lead-related nephrotoxicity: a review of the epidemiologic evidence.

Authors
Ekong-EB; Jaar-BG; Weaver-VM
Source
Kidney Int 2006 Dec; 70(12):2074-2084
NIOSHTIC No.
20037539
Abstract
Chronic kidney disease (CKD) represents a major global public health concern. Efforts to prevent and/or slow progression of CKD are essential. Lead nephropathy, characterized by chronic tubulointerstitial nephritis, is a well-known risk of chronic, high-level lead exposure. However, in recent years, lead exposure has declined sharply, particularly in developed countries. We reviewed epidemiologic research in general, occupational, and patient populations to assess whether lead, at current exposure levels, still contributes to nephrotoxicity. Other pertinent topics, such as risk in children, genetic susceptibility, and co-exposure to cadmium, are also considered. The data reviewed indicate that lead contributes to nephrotoxicity, even at blood lead levels below 5 microg/dl. This is particularly true in susceptible populations, such as those with hypertension (HTN), diabetes, and/or CKD. Low socioeconomic status is a risk factor for both lead exposure and diseases that increase susceptibility. Future public health risk for lead-related nephrotoxicity may be most significant in those rapidly developing countries where risk factors for CKD, including obesity and secondary HTN and diabetes mellitus, are increasing more rapidly than lead exposure is declining. Global efforts to reduce lead exposure remain important. Research is also needed to determine whether specific therapies, such as chelation, are beneficial in susceptible populations.
Keywords
Kidney-disorders; Kidneys; Kidney-damage; Lead-poisoning; Lead-absorption; Epidemiology; Exposure-levels; Exposure-assessment; Nephrotoxicity; Chronic-exposure; Humans; Biomarkers; Author Keywords: Environmental-lead-exposure; Kidney-function; occupational-lead exposure; Renal-biomarkers
Contact
VM Weaver, Division of Occupational and Environmental Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Rm. 7041, Baltimore, Maryland 21205, USA
CODEN
KDYIA5
CAS No.
7439-92-1
Publication Date
20061201
Document Type
Journal Article
Email Address
vweaver@jhsph.edu
Funding Type
Grant
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008428
Issue of Publication
12
ISSN
0085-2538
Source Name
Kidney International
State
MD
Performing Organization
Johns Hopkins University
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