title: Renal effects of exposure to natural and depleted uranium: a review of the epidemiologic and experimental data.
abstract: Elevated levels of naturally occurring uranium in groundwater have been found in small geographic areas throughout the world. Relevant research was reviewed pertaining to natural and depleted uranium (DU) exposure and nephrotoxicity, including epidemiologic community-based and occupational studies, studies of Gulf War veterans exposed to DU, and experimental studies in animals. Occupational cohort studies do not provide evidence of an increased risk of kidney-related mortality among uranium-exposed workers. However, occupational and community-based studies of populations chronically exposed to elevated drinking-water concentrations of uranium provide some evidence of adverse renal effects, as assessed by biomarkers of proximal tubule damage such as urinary levels of glucose, calcium, and various low-molecular-weight proteins. Indications of proximal tubule effects, as evidenced by increased urinary β(2)-microglobulin and retinol binding protein levels, were also seen in the most recent follow-up surveillance study of Gulf War veterans exposed to DU. The reported β(2)-microglobulin levels in these studies were generally considered to be within normal limits, but the long-term implications of the observed variation in these levels are not established. The kidney was observed to be a target of uranium toxicity following oral and implantation exposure routes in several animal species. The interpretation and importance of the observed changes in biomarkers of proximal tubule function are important questions that indicate the need for additional clinical, epidemiological, and experimental research.
authors.affiliation: National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington, DC 20460, USA.
authors.forename: Xabier
authors.initials: X
authors.lastname: Arzuaga
authors.forename: Susan H
authors.initials: SH
authors.lastname: Rieth
authors.forename: Ambika
authors.initials: A
authors.lastname: Bathija
authors.forename: Glinda S
authors.initials: GS
authors.lastname: Cooper
mesh_terms: D000818:Animals; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D047830:Gulf War; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000528:radiation effects; D007674:Kidney Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D011817:Rabbits; D011877:Radionuclide Imaging; D051381:Rats; D014501:Uranium / Q000032:analysis / Q000633:toxicity*; D014728:Veterans; D014881:Water Supply / Q000032:analysis
chemical_list: D014501:Uranium