title: Association of tibia lead and blood lead with end-stage renal disease: a pilot study of African-Americans.
abstract: The association between body lead burden and kidney disease remains controversial. Fifty-five African-American end-stage renal disease (ESRD) cases and 53 age- and sex-matched African-American controls without known renal disease were recruited from Tulane University-affiliated dialysis clinics and out-patient clinics, respectively. Blood lead was measured via atomic absorption spectrophotometry and tibia lead (a measure of body lead) was measured via (109)Cd-based K shell X-ray fluorescence. Median blood lead levels were significantly higher among ESRD cases (6 microg/dL) compared to their control counterparts (3 microg/dL; P<0.001). Although no participants had overt lead poisoning (blood lead > or = 25 microg/dL), seven cases but no controls had blood lead levels above 10 microg/dL (P=0.006). The median tibia lead level was 17 micrograms of lead per gram of bone mineral (microg/g) and 13 microg/g among ESRD cases and their control counterparts, respectively (P=0.134). Four ESRD cases (7%), but no controls, had a tibia lead level above 40 microg/g (P=0.115) while a similar proportion of cases and controls had tibia lead between 20 and 39 microg/g (33% and 32%, respectively; P=0.726). After adjustment for potential confounders, the odds ratios of ESRD associated with a tibia lead > or = 20 microg/g and each four-fold higher tibia lead (e.g., 5-20 microg/g) were 1.55 (95% CI: 0.55, 4.41) and 1.88 (95% CI: 0.53, 6.68), respectively. These findings support the need for prospective cohort studies of body lead burden and renal disease progression.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA. pmuntner@tulane.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Andy
authors.initials: A
authors.lastname: Menke
authors.forename: Vecihi
authors.initials: V
authors.lastname: Batuman
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Rabito
authors.forename: Jiang
authors.initials: J
authors.lastname: He
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Todd
mesh_terms: D001741:Black or African American; D004785:Environmental Pollutants / Q000032:analysis / Q000097:blood* / Q000493:pharmacokinetics / Q000633:toxicity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000208:ethnology / Q000209:etiology; D007854:Lead / Q000032:analysis / Q000097:blood* / Q000493:pharmacokinetics / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011859:Radiography; D013052:Spectrometry, X-Ray Emission; D013977:Tibia / Q000000981:diagnostic imaging / Q000378:metabolism*
chemical_list: D004785:Environmental Pollutants; D007854:Lead