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Blood Lead Levels and Decreased Kidney Function in a Population-Based Cohort.

Artikel i vetenskaplig tidskrift
Författare Florencia Harari
Gerd Sällsten
Anders Christensson
Marinka Petkovic
Bo Hedblad
Niklas Forsgard
Olle Melander
Peter M Nilsson
Yan Borné
Lars Barregård
Publicerad i American journal of kidney diseases : the official journal of the National Kidney Foundation
Volym 72
Nummer/häfte 3
Sidor 381-389
ISSN 1523-6838
Publiceringsår 2018
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Sidor 381-389
Språk en
Länkar dx.doi.org/10.1053/j.ajkd.2018.02.3...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Miljömedicin och yrkesmedicin

Sammanfattning

Environmental lead exposure has been associated with decreased kidney function, but evidence from large prospective cohort studies examining low exposure levels is scarce. We assessed the association of low levels of lead exposure with kidney function and kidney disease.Prospective population-based cohort.4,341 individuals aged 46 to 67 years enrolled into the Malmö Diet and Cancer Study-Cardiovascular Cohort (1991-1994) and 2,567 individuals subsequently followed up (2007-2012).Blood lead concentrations in quartiles (Q1-Q4) at baseline.Change in estimated glomerular filtration rate (eGFR) between the baseline and follow-up visit based on serum creatinine level alone or in combination with cystatin C level. Chronic kidney disease (CKD) incidence (185 cases) through 2013 detected using a national registry.Multivariable-adjusted linear regression models to assess associations between lead levels and eGFRs at baseline and follow-up and change in eGFRs over time. Cox regression was used to examine associations between lead levels and CKD incidence. Validation of 100 randomly selected CKD cases showed very good agreement between registry data and medical records and laboratory data.At baseline, 60% of study participants were women, mean age was 57 years, and median lead level was 25 (range, 1.5-258) μg/L. After a mean of 16 years of follow-up, eGFR decreased on average by 6mL/min/1.73m2 (based on creatinine) and 24mL/min/1.73m2 (based on a combined creatinine and cystatin C equation). eGFR change was higher in Q3 and Q4 of blood lead levels compared with Q1 (P for trend = 0.001). The HR for incident CKD in Q4 was 1.49 (95% CI, 1.07-2.08) compared with Q1 to Q3 combined.Lead level measured only at baseline, moderate number of CKD cases, potential unmeasured confounding.Low-level lead exposure was associated with decreased kidney function and incident CKD. Our findings suggest lead nephrotoxicity even at low levels of exposure.

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Denna text är utskriven från följande webbsida:
http://www.gu.se/forskning/publikation/?publicationId=276686
Utskriftsdatum: 2019-08-20