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

Sommar, Johan Nilsson; Svensson, Maria K.; Bjor, Bodil M.; Elmståhl, Sölve LU ; Hallmans, Goran; Lundh, Thomas LU ; Schon, Staffan M. I.; Skerfving, Staffan LU and Bergdahl, Ingvar A. (2013) In Environmental Health 12.
Abstract
Background: Cadmium (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. Methods: A 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. Results: Erythrocyte lead was associated with an increased risk of developing end-stage renal disease (mean... (More)
Background: Cadmium (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. Methods: A 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. Results: Erythrocyte lead was associated with an increased risk of developing end-stage renal disease (mean in cases 76 mu g/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 mu g/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 mu g/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. Conclusions: Erythrocyte 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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biobank, Cadmium, Case-referent, End-stage renal disease, Lead, Mercury
in
Environmental Health
volume
12
publisher
BioMed Central
external identifiers
  • wos:000314983200001
  • scopus:84880357230
ISSN
1476-069X
DOI
10.1186/1476-069X-12-9
language
English
LU publication?
yes
id
a3730442-51cf-4b6d-b6a9-904a3cb97714 (old id 3580942)
date added to LUP
2013-04-02 07:45:51
date last changed
2019-02-10 03:57:26
@article{a3730442-51cf-4b6d-b6a9-904a3cb97714,
  abstract     = {Background: Cadmium (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. Methods: A 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. Results: Erythrocyte lead was associated with an increased risk of developing end-stage renal disease (mean in cases 76 mu g/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 mu g/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 mu g/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. Conclusions: Erythrocyte 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.},
  author       = {Sommar, Johan Nilsson and Svensson, Maria K. and Bjor, Bodil M. and Elmståhl, Sölve and Hallmans, Goran and Lundh, Thomas and Schon, Staffan M. I. and Skerfving, Staffan and Bergdahl, Ingvar A.},
  issn         = {1476-069X},
  keyword      = {Biobank,Cadmium,Case-referent,End-stage renal disease,Lead,Mercury},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Environmental Health},
  title        = {End-stage renal disease and low level exposure to lead, cadmium and mercury; a population-based, prospective nested case-referent study in Sweden},
  url          = {http://dx.doi.org/10.1186/1476-069X-12-9},
  volume       = {12},
  year         = {2013},
}