Co-exposures to toxic metals cadmium, lead, and mercury and their impact on unhealthy kidney function

Jain, Ram B.

doi:10.1007/s11356-019-06182-y

Cited by 28 publications

(25 citation statements)

References 31 publications

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“…Although we did not find a correlation between PbB and CdB levels, an interesting result from our analysis was the higher risk of decreased eGFR with increased PbB and CdB in the highest tertile. The relationship between our variables is comparable with the literature, but the magnitude of risk is 10-fold greater than Jain (2019) and Navas-Acien et al (2009) [ 42 , 43 ]. Jain (2019) performed an analysis like ours stratified PbB and CdB into high and low, and calculated adjusted odds ratios for combinations [ 42 ].…”

Section: Discussionsupporting

confidence: 90%

“…The magnitude and significance of their ORs were comparable to Navas-Acien et al’s (2009) joint analysis of PbB and CdB levels on reduced eGFR [ 43 ]. Both Navas-Acien et al (2009) and Jain (2019) were using the US NHANES cohort data and were able to adjust for more sociodemographic variables in their linear and logistic regression models [ 42 , 43 ]. Chen et al (2019) measured PbB and CdB in a Chinese cohort but only found a significant joint association with a reduction in urinary NAG activities [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

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A Cross-Sectional Analysis Investigating Pregnant Women’s Renal Function and Its Association with Lead and Cadmium Exposures—The DSAN Birth Cohort Study in Recôncavo Baiano, Brazil

Di Giuseppe,

Ferréol Bah,

Gomes Júnior

et al. 2024

Toxics

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Kidney dysfunction is increasing worldwide and is exacerbated by exposure to toxic metals. Also, pregnancy poses an overload on kidney function. We investigated how blood lead (PbB) and cadmium (CdB) levels were associated with kidney function in pregnant women from Recôncavo Baiano, Brazil, during their second trimester. In this cross-sectional study, the estimated glomerular filtration rate (eGFR) was calculated from serum creatinine and whole blood metal levels were measured by graphite furnace atomic absorption spectrophotometry in 136 volunteers. Sociodemographic data were collected using semi-structured questionnaires. The medians (IQR) of PbB, CdB, and eGFR were 0.85 µg/dL (0.45–1.75), 0.55 µg/L (0.08–0.91), and 121.8 mL/min/1.73 m2 (106.0–127.9), respectively. PbB medians were significantly higher in the eGFR < 90 group at 2.00 µg/dL (0.83, 3.10). After age-adjusted logistic regression, pregnant women with elevated PbB levels had decreased eGFR (OR = 1.82; 95%-CI, 1.14–3.14). However, the participants with elevated PbB levels who reported consuming alcohol during pregnancy or had CdB in the highest tertile had higher odds of reduced eGFR (OR = 2.44; 95%-CI, 1.30–5.47) and (OR = 11.22; 95% CI, 2.53–103.51), respectively. These results suggest that low Pb exposure may affect kidney function in pregnant women and calls for further investigation into toxic metal co-exposures on kidney function during pregnancy in at-risk communities.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Analysis Investigating Pregnant Women’s Renal Function and Its Association with Lead and Cadmium Exposures—The DSAN Birth Cohort Study in Recôncavo Baiano, Brazil

Di Giuseppe,

Ferréol Bah,

Gomes Júnior

et al. 2024

Toxics

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“…Sanders et al found associations between metals (Hg, As, Cd, and Pb) in urine with eGFR, but there was no significant difference between blood metal mixtures in the general population by WQS regression [ 52 ]. Research showed high levels of blood Pb and Cd were associated with renal function (adjusted odds ratios: 2.369, 95%: 1.868–3.004) in a general population of adults from the National Health and Nutrition Examine Survey (NHANES) dataset [ 53 ]. Our findings on the toxic mixture model are similar to those identified by Luo et al, who reported Pb was the major association with eGFR compared to the other metals in the mixture model [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Use of Generalized Weighted Quantile Sum Regressions of Tumor Necrosis Factor Alpha and Kidney Function to Explore Joint Effects of Multiple Metals in Blood

Luo

Yang³

et al. 2022

IJERPH

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Exposure to heavy metals could lead to adverse health effects by oxidative reactions or inflammation. Some essential elements are known as reactors of anti-inflammatory enzymes or coenzymes. The relationship between tumor necrosis factor alpha (TNF-α) and heavy metal exposures was reported. However, the interaction between toxic metals and essential elements in the inflammatory response remains unclear. This study aimed to explore the association between arsenic (As), cadmium (Cd), lead (Pb), cobalt (Co), copper (Cu), selenium (Se), and zinc (Zn) in blood and TNF-α as well as kidney function. We enrolled 421 workers and measured the levels of these seven metals/metalloids and TNF-α in blood; kidney function was calculated by CKD-EPI equation. We applied weighted quantile sum (WQS) regression and group WQS regression to assess the effects of metal/metalloid mixtures to TNF-α and kidney function. We also approached the relationship between metals/metalloids and TNF-α by generalized additive models (GAM). The relationship of the exposure–response curve between Pb level and TNF-α in serum was found significantly non-linear after adjusting covariates (p < 0.001). Within the multiple-metal model, Pb, As, and Zn were associated with increased TNF-α levels with effects dedicated to the mixture of 50%, 31%, and 15%, respectively. Grouped WQS revealed that the essential metal group showed a significantly negative association with TNF-α and kidney function. The toxic metal group found significantly positive associations with TNF-α, serum creatinine, and WBC but not for eGFR. These results suggested Pb, As, Zn, Se, and mixtures may act on TNF-α even through interactive mechanisms. Our findings offer insights into what primary components of metal mixtures affect inflammation and kidney function during co-exposure to metals; however, the mechanisms still need further research.

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“…A Thai study showed that long-term exposure to a low cadmium level was associated with decreased renal function [27]. Another study reported that exposure to high levels of lead and cadmium reduced eGFR and increased the albumin to creatinine ratio, adversely affecting renal function [28]. Furthermore, recent studies have revealed that with an increase in plasma cadmium concentration, the risks of long-term kidney transplant failure and reduced kidney function increase [29].…”

Section: Discussionmentioning

confidence: 99%

Plasma Vitamin B12 and Folate Alter the Association of Blood Lead and Cadmium and Total Urinary Arsenic Levels with Chronic Kidney Disease in a Taiwanese Population

et al. 2021

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Heavy metals causing chronic nephrotoxicity may play a key role in the pathogenesis of chronic kidney disease (CKD). This study hypothesized that plasma folate and vitamin B12 would modify the association of CKD with total urinary arsenic and blood lead and cadmium levels. We recruited 220 patients with CKD who had an estimated glomerular filtration rate of <60 mL/min/1.73 m2 for ≥3 consecutive months and 438 sex- and age-matched controls. We performed inductively coupled plasma mass spectrometry to measure blood cadmium and lead levels. The urinary arsenic level was determined using a high-performance liquid chromatography–hydride generator–atomic absorption spectrometry. Plasma vitamin B12 and folate levels were measured through the SimulTRAC-SNB radioassay. Compared with patients with plasma vitamin B12 ≤ 6.27 pg/mL, the odds ratio (OR) and 95% confidence interval of CKD for patients with plasma vitamin B12 > 9.54 pg/mL was 2.02 (1.15–3.55). However, no association was observed between plasma folate concentration and CKD. A high level of plasma vitamin B12 combined with high levels of blood lead and cadmium level and total urinary arsenic tended to increase the OR of CKD in a dose-response manner, but the interactions were nonsignificant. This is the first study to demonstrate that patients with high plasma vitamin B12 level exhibit increased OR of CKD related to high levels of blood cadmium and lead and total urinary arsenic.

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Co-exposures to toxic metals cadmium, lead, and mercury and their impact on unhealthy kidney function

Cited by 28 publications

References 31 publications

A Cross-Sectional Analysis Investigating Pregnant Women’s Renal Function and Its Association with Lead and Cadmium Exposures—The DSAN Birth Cohort Study in Recôncavo Baiano, Brazil

A Cross-Sectional Analysis Investigating Pregnant Women’s Renal Function and Its Association with Lead and Cadmium Exposures—The DSAN Birth Cohort Study in Recôncavo Baiano, Brazil

Use of Generalized Weighted Quantile Sum Regressions of Tumor Necrosis Factor Alpha and Kidney Function to Explore Joint Effects of Multiple Metals in Blood

Plasma Vitamin B12 and Folate Alter the Association of Blood Lead and Cadmium and Total Urinary Arsenic Levels with Chronic Kidney Disease in a Taiwanese Population

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