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Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data.
Environ Res. 2012 Oct; 118:124-9.ER

Abstract

INTRODUCTION

The objective of this study was to evaluate associations between blood lead, cadmium, and mercury levels with estimated glomerular filtration rate in a general population of South Korean adults.

METHODS

This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010). The final analytical sample consisted of 5924 participants. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD Study equation as an indicator of glomerular function.

RESULTS

In multiple linear regression analysis of log2-transformed blood lead as a continuous variable on eGFR, after adjusting for covariates including cadmium and mercury, the difference in eGFR levels associated with doubling of blood lead were -2.624 mL/min per 1.73 m² (95% CI: -3.803 to -1.445). In multiple linear regression analysis using quartiles of blood lead as the independent variable, the difference in eGFR levels comparing participants in the highest versus the lowest quartiles of blood lead was -3.835 mL/min per 1.73 m² (95% CI: -5.730 to -1.939). In a multiple linear regression analysis using blood cadmium and mercury, as continuous or categorical variables, as independent variables, neither metal was a significant predictor of eGFR. Odds ratios (ORs) and 95% CI values for reduced eGFR calculated for log2-transformed blood metals and quartiles of the three metals showed similar trends after adjustment for covariates.

DISCUSSION

In this large, representative sample of South Korean adults, elevated blood lead level was consistently associated with lower eGFR levels and with the prevalence of reduced eGFR even in blood lead levels below 10 μg/dL. In conclusion, elevated blood lead level was associated with lower eGFR in a Korean general population, supporting the role of lead as a risk factor for chronic kidney disease.

Authors+Show Affiliations

Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22749111

Citation

Kim, Yangho, and Byung-Kook Lee. "Associations of Blood Lead, Cadmium, and Mercury With Estimated Glomerular Filtration Rate in the Korean General Population: Analysis of 2008-2010 Korean National Health and Nutrition Examination Survey Data." Environmental Research, vol. 118, 2012, pp. 124-9.
Kim Y, Lee BK. Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data. Environ Res. 2012;118:124-9.
Kim, Y., & Lee, B. K. (2012). Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data. Environmental Research, 118, 124-9. https://doi.org/10.1016/j.envres.2012.06.003
Kim Y, Lee BK. Associations of Blood Lead, Cadmium, and Mercury With Estimated Glomerular Filtration Rate in the Korean General Population: Analysis of 2008-2010 Korean National Health and Nutrition Examination Survey Data. Environ Res. 2012;118:124-9. PubMed PMID: 22749111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data. AU - Kim,Yangho, AU - Lee,Byung-Kook, Y1 - 2012/06/27/ PY - 2012/01/21/received PY - 2012/05/18/revised PY - 2012/06/05/accepted PY - 2012/7/4/entrez PY - 2012/7/4/pubmed PY - 2012/11/14/medline SP - 124 EP - 9 JF - Environmental research JO - Environ. Res. VL - 118 N2 - INTRODUCTION: The objective of this study was to evaluate associations between blood lead, cadmium, and mercury levels with estimated glomerular filtration rate in a general population of South Korean adults. METHODS: This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010). The final analytical sample consisted of 5924 participants. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD Study equation as an indicator of glomerular function. RESULTS: In multiple linear regression analysis of log2-transformed blood lead as a continuous variable on eGFR, after adjusting for covariates including cadmium and mercury, the difference in eGFR levels associated with doubling of blood lead were -2.624 mL/min per 1.73 m² (95% CI: -3.803 to -1.445). In multiple linear regression analysis using quartiles of blood lead as the independent variable, the difference in eGFR levels comparing participants in the highest versus the lowest quartiles of blood lead was -3.835 mL/min per 1.73 m² (95% CI: -5.730 to -1.939). In a multiple linear regression analysis using blood cadmium and mercury, as continuous or categorical variables, as independent variables, neither metal was a significant predictor of eGFR. Odds ratios (ORs) and 95% CI values for reduced eGFR calculated for log2-transformed blood metals and quartiles of the three metals showed similar trends after adjustment for covariates. DISCUSSION: In this large, representative sample of South Korean adults, elevated blood lead level was consistently associated with lower eGFR levels and with the prevalence of reduced eGFR even in blood lead levels below 10 μg/dL. In conclusion, elevated blood lead level was associated with lower eGFR in a Korean general population, supporting the role of lead as a risk factor for chronic kidney disease. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/22749111/Associations_of_blood_lead_cadmium_and_mercury_with_estimated_glomerular_filtration_rate_in_the_Korean_general_population:_analysis_of_2008_2010_Korean_National_Health_and_Nutrition_Examination_Survey_data_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(12)00186-7 DB - PRIME DP - Unbound Medicine ER -