Prospective associations between environmental heavy metal exposure and renal outcomes in adults with chronic kidney disease

• DOI: 10.1111/nep.13089
• Publication Date: 2017-06-20T20:16:46Z
• Authors: Chun‐Chieh Tsai; Chia‐Lin Wu; Chew‐Teng Kor; Ie‐Bin Lian; Chin‐Hua Chang; Teng‐Hsiang Chang; Chia‐Chu Chang; Ping‐Fang Chiu
• Keywords: Male; Time Factors; Taiwan; Environmental Exposure; Middle Aged; Kidney; Risk Assessment; 01 natural sciences; 3. Good health; Soil; Renal Dialysis; Risk Factors; Metals, Heavy; Disease Progression; Humans; Kidney Failure, Chronic; Environmental Pollutants; Female; Renal Insufficiency, Chronic; Aged; Glomerular Filtration Rate; Retrospective Studies; 0105 earth and related environmental sciences

In Taiwan, Changhua County residents were exposed to high heavy metal pollution and exhibited levels in blood urine. We examined associations between metals residential soil renal outcomes of with chronic kidney disease (CKD).From 1 January 2003 30 June 2015, we retrospectively identified CKD patients an estimated glomerular filtration rate <60 mL/min per 1.73 m2 at one tertiary care centre. linked data displaying concentrations from farm adjacent the patients' residences clinical outcomes. included 2343 (533 progression end-stage [ESRD] 1810 without]. followed these for 3.49 ± 2.27 years, until death or initiation maintenance dialysis.There correlations among eight metals: arsenic, cadmium, chromium, mercury, copper, lead, nickel, zinc. After factor analysis, zinc grouped labelled Factor 1. High concentration near was associated diagnoses hypertension, diabetes mellitus, cerebral vascular accident. Patients living areas higher risk ESRD. multivariate adjustment [adjusted hazard ratio: 1.08, 95% Confidence interval: 1.01-1.14, P = 0.02], only nickel factors ESRD.Patients CKD, long-term exposure soil-based metals, had rapid Groups minerals same source contamination may accumulate lead additional harm.