End-stage renal disease and low level exposure to lead, cadmium and mercury; a population-based, prospective nested case-referent study in Sweden

Environmental Health

Research

Sölve I Elmståhl¹  Maria K Svensson²  Göran Hallmans³  Bodil M Björ⁴  Johan Nilsson Sommar⁴  Ingvar A Bergdahl⁴  Staffan MI Schön⁵  Staffan Skerfving⁶  Thomas Lundh⁶ 

[1] Department of Health Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden;Department of Molecular and Clinical Medicine-Nephrology, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden;Department of Public Health and Clinical Medicine, Nutritional Research, Umea University, Umea, Sweden;Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umea University, Umea, Sweden;Diaverum Renal Services Group, Lund, Sweden & Swedish Renal Registry, Jönköping, Sweden;Division of Occupational and Environmental Medicine, University Hospital, Lund, Sweden;

关键词: Biobank;    Cadmium;    Case-referent;    End-stage renal disease;    Lead;    Mercury;   

DOI  :  10.1186/1476-069X-12-9

 received in 2012-09-18, accepted in 2013-01-19,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundCadmium (Cd), lead (Pb), and mercury (Hg) cause toxicological renal effects, but the clinical relevance at low-level exposures in general populations is unclear. The objective of this study is to assess the risk of developing end-stage renal disease in relation to Cd, Pb, and Hg exposure.MethodsA total of 118 cases who later in life developed end-stage renal disease, and 378 matched (sex, age, area, and time of blood sampling) referents were identified among participants in two population-based prospective cohorts (130,000 individuals). Cd, Pb, and Hg concentrations were determined in prospectively collected samples.ResultsErythrocyte lead was associated with an increased risk of developing end-stage renal disease (mean in cases 76 μg/L; odds ratio (OR) 1.54 for an interquartile range increase, 95% confidence interval (CI) 1.18-2.00), while erythrocyte mercury was negatively associated (2.4 μg/L; OR 0.75 for an interquartile range increase, CI 0.56-0.99). For erythrocyte cadmium, the OR of developing end-stage renal disease was 1.15 for an interquartile range increase (CI 0.99-1.34; mean Ery-Cd among cases: 1.3 μg/L). The associations for erythrocyte lead and erythrocyte mercury, but not for erythrocyte cadmium, remained after adjusting for the other two metals, smoking, BMI, diabetes, and hypertension. Gender-specific analyses showed that men carried almost all of the erythrocyte lead and erythrocyte cadmium associated risks.ConclusionsErythrocyte lead is associated with end-stage renal disease but further studies are needed to evaluate causality. Gender-specific analyses suggest potential differences in susceptibility or in exposure biomarker reliability.

【 授权许可】

CC BY   
© Sommar et al.; licensee BioMed Central Ltd. 2013