Environmental Lead Exposure and Progressive Renal Insufficiency

Abstract

Long-term low-level environmental lead exposure may subtly affect progressive renal insufficiency in the general population. Progressive renal insufficiency may be improved for at least 1 year after lead chelating therapy. Further investigations are needed to clarify this observation.

Characterizing Golden Eagle Risk to Lead and Anticoagulant Rodenticide Exposure: A Review

“…The observations suggestive of a relationship between PbB and decrements in glomerular filtration rate derived from the studies presented in Table 3-3 are consistent with those of a smaller prospective clinical study in which progression of renal insufficiency was related to higher lead body burden among patients whose PbB was <15 μg/dL (Lin et al 2001;Yu et al 2004). Mean PbB in a high lead body burden group (EDTA provocation test yielded >600 μg excreted/72 hours) were 6.6 μg/dL (range, 1.0-15 μg/dL) compared to 3.9 μg/dL (1-7.9 μg/dL) in a low body burden group.…”

“…Measurements of urinary lead levels have been used to assess lead exposure (e.g., Fels et al 1998;Gerhardsson et al 1992;Lilis et al 1968;Lin et al 2001;Mortada et al 2001;Roels et al 1994). However, like PbB, urinary lead excretion reflects, mainly, recent exposure and, thus, shares many of the same limitations for assessing lead body burden or long-term exposure (Sakai 2000;Skerfving 1988).…”

The pitfalls of hair analysis for toxicants in clinical practice: three case reports.

“…Chelation therapy has not been shown to improve outcomes in patients with the clinical presentations described and the low levels of mercury seen in cases 1 and 2 (12). There is some evidence that chelation in patients with renal insufficiency and low-to-moderate chelatablelead levels improves creatinine clearance over time (13), but patient 3 did not have renal insufficiency and his lead level was lower than those described by Lin et al (13). In view of the lack of evidence on the efficacy and safety of chelation treatment in patients with lowto-moderate metal exposures, removal of the individual from the exposure is the therapeutic approach most favored (12).…”

Do people from Taiwan have higher heavy metal levels than those from Western countries?

“…According to recent reports, body lead burden can be measured by collecting 72-hour urinary lead excretion after intravenous infusion of 1 g of CaNa 2 EDTA. (8,9) These reports recommend the daily collection of urine for 72 hours in a high-volume container before the urine is sent for lead measurement. If most of the lead (or other heavy metal) can be excreted during the first 24 hours after CaNa 2 EDTA infusion, then the level of heavy metal in the urine during the first 24 hours may be reflective of the body burden of these heavy metals.…”