Korean Journal of Nephrology 2011;30(6):607-613.
Association of Blood and Bone Lead with a Decrease in Renal Function Indices in Patients with Chronic Kidney Disease
Jong-Oh Yang, M.D.1, Nam-Soo Kim, Ph.D.2, Eun-Young Lee, M.D.1, Sae-Yong Hong, M.D.1, Andrew C. Todd, Ph.D.3 and Byung-Kook Lee, M.D.2
Department of Internal Medicine1
College of Medicine, Soonchunhyang University, Institute of Environmental and Occupational Medicine2
College of Medicine, Soonchunhyang University Department of Community and Preventive Medicine3
Mount Sinai School of Medicine, New York, New York, USA
원저 :만성 신질환에서 혈중납량 및 골중납량과 신기능 저하의 관련성
양종오1 , 김남수2 , 이은영1 , 홍세용1 , Andrew C. Todd3 , 이병국2
순천향대학교 의과대학 내과학교실1 , 순천향대학교 의과대학 환경산업의학연구소2, 마운트사이나대학교 지역사회 및 예방의학교실3
Purpose: This study assessed the environmental lead exposure in patients with chronic kidney disease (CKD) and the relationship between lead exposure and renal function indices. Methods: Seventy-one patients with CKD and 40 control subjects without known renal disease were included. Blood lead was measured by atomic absorption spectrophotometry and tibial lead was measured via 109Cd-based K-shell X-ray fluorescence. Blood urea nitrogen (BUN), serum creatinine, urine creatinine and urine N-acetyl-beta glucosaminidase (NAG) were also measured. Blood lead was corrected with hematocrit (female: 35%, male: 42%) to adjust for differences in anemic status of patients compared with control subjects. Results: The mean level of hematocrit-adjusted blood lead was significantly higher in patients with CKD (4.18±1.74 μg/dL) compared with that in control subjects (3.00±0.92 μg/dL); the mean tibial lead level tended to be higher in patients with CKD (3.38±9.93 μg/g) than that in control subjects (1.28±7.92 μg/ g), but no statistical significance was observed. In a multivariate regression analysis after adjusting for gender, age, and drinking and smoking status, adjusted blood lead was a significant predictor of increases in BUN and serum creatinine, but not of the level of urine NAG or creatinine. In contrast, no significant association between tibial lead and renal indices was observed in the multivariate regression analysis. Conclusion: These results suggest that environmental lead exposure may compromise renal function.
Key Words: Lead, Chronic kidney disease, Renal function

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