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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Studies evaluating the role of lead in CKD

Studies evaluating the role of lead in CKD
Reference N Baseline mean (SD) blood lead (microgram/dL) Baseline mean (SD) chelatable lead (microgram/72 hours) Baseline mean (SD) eGFR (mL/min/1.73 m2) Follow-up (years) Decline in eGFR per 1 SD higher lead dose at baseline per year Comments
[1] 202 5.3 (2.9) 104.5 (106.3) 41.6 (14.4) two 0.16 Largest study to date
[2] 121 4.2 (2.2) 99.1 (83.4) 36.0 (9.8) four

2.7 (chelatable)

2.2 (blood lead)

 Longest follow-up; 1 microgram/dL higher blood lead, at baseline, associated with 4.0 mL/min/1.73 m2 reduction in eGFR over four years
[3] 87 6.5 (3.4) 108.5 (53.8) 35.1 (9.0) one 3.87 Type II diabetics with nephropathy
[4] 108 2.9 (1.4)* 40.2 (21.2) (all <80) 47.6 (9.8) two 1.1 Lowest lead exposed CKD patients
[5] 434 participants with ESRD  Categories based on highest prior blood lead level in lead surveillance program: <5, 5 to <25, 25 to <40, 40 to <50, ≥50 mcg/dL N/A  ESRD based on inclusion in USRDS  Median of 2.7  No association between highest blood lead levels measured before and survival after ESRD diagnosis  Occupational lead exposure; ESRD
[6]  801 Occupational exposure based on expert rating method using job history  N/A  Mean eGFR <20 mL/min/1.73 m2  Mean of 2.5  Progression did not differ by occupational lead exposures  ESRD; occupational exposure in 70 participants 
SD: standard deviation; eGFR: estimated glomerular filtration rate; CKD: chronic kidney disease; ESRD: end-stage renal disease; USRDS: United States Renal Data System.
* Notably, mean blood lead level in this study was below that observed in a large general population study of 50 to 70 year olds in Baltimore, MD[7].
References:
  1. Lin JL, Lin-Tan DT, Hsu KH, Yu CC. Environmental lead exposure and progression of chronic renal diseases in patients without diabetes. N Engl J Med 2003; 348:277.
  2. Yu CC, Lin JL, Lin-Tan DT. Environmental exposure to lead and progression of chronic renal diseases: a four-year prospective longitudinal study. J Am Soc Nephrol 2004; 15:1016.
  3. Lin JL, Lin-Tan DT, Yu CC, et al. Environmental exposure to lead and progressive diabetic nephropathy in patients with type II diabetes. Kidney Int 2006; 69:2049.
  4. Lin JL, Lin-Tan DT, Li YJ, et al. Low-level environmental exposure to lead and progressive chronic kidney diseases. Am J Med 2006; 119:707.
  5. Chowdhury R, Mukhopadhyay A, McClellan W, et al. Survival patterns of lead-exposed workers with end-stage renal disease from Adult Blood Plead Epidemiology and Surveillance program. Am J Med Sci 2015; 349:222.
  6. Evans M. Fored CM, Nise G, et al. Occupational lead exposure and severe CKD: A population-based case-control and prospective observational cohort study in Sweden. Am J Kidney Dis 2010; 55:497.
  7. Martin D, Glass TA, Bandeen-Roche K, et al. Association of blood lead and tibia lead with blood pressure and hypertension in a community sample of older adults. Am J Epidemiol 2006; 163:467.
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