Negative Relationship between Erythropoietin Dose and Blood Lead Level in Patients Undergoing Maintenance Hemodialysis.
The adverse effects of increased blood lead levels have been well discussed. Several antioxidant agents have been reported to offer protection from lead toxicity and to reduce blood lead levels (BLL). Given that erythropoietin (EPO) also has antioxidant properties, the aim of this cross-sectional study was to assess the role of EPO and other clinical variables on BLL in hemodialysis (HD) patients. We recruited 931 maintenance hemodialysis (MHD) patients who had undergone HD for at least 6 months and who had ever received blood lead level (BLL) study. Use of erythropoiesis-stimulating agents followed the The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) Clinical Practice Guideline. We estimated demographic, hematological, nutritional, inflammatory, biochemical, and dialysis-related data based on this study. In the group with EPO, 7% had high BLL. In the group without EPO, 22% had high BLL. From the stepwise liner regression, urban areas, hemodialysis duration, and clearance of urea (KT/Vurea) were positively associated with log BLL. In contrast, diabetes (DM), and monthly EPO dose were negatively associated with log BLL. This study showed that EPO dose might be negatively associated with blood lead levels in patients on maintenance hemodialysis.
Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, R.O.C., Taiwan.|Chang Gung University College of Medicine, Taoyuan, R.O.C., Taiwan.
Wen-Hung
WH
Huang
Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, R.O.C., Taiwan.|Chang Gung University College of Medicine, Taoyuan, R.O.C., Taiwan.
Ching-Wei
CW
Hsu
Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, R.O.C., Taiwan.|Chang Gung University College of Medicine, Taoyuan, R.O.C., Taiwan.
Cheng-Hao
CH
Weng
Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, R.O.C., Taiwan.
Dan-Tzu
DT
Lin-Tan
Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, R.O.C., Taiwan.|Chang Gung University College of Medicine, Taoyuan, R.O.C., Taiwan.
Tzung-Hai
TH
Yen
Occup Environ Med. 1999 Feb;56(2):106-9
10448314
Arch Toxicol. 1988;62(4):301-4
3240094
Neurosci Lett. 2002 Mar 15;321(1-2):73-6
11872260
Biol Trace Elem Res. 2013 Dec;156(1-3):79-90
24222606
N Engl J Med. 2003 Jan 23;348(4):277-86
12540640
Am J Nephrol. 1993;13(3):198-202
8213931
Am J Med. 2011 Apr;124(4):350-8
21435426
Int J Artif Organs. 1989 Jul;12(7):411-9
2767786
Int Arch Occup Environ Health. 2007 Feb;80(4):342-5
16838166
Am J Kidney Dis. 2008 Jan;51(1):107-15
18155539
N Engl J Med. 1992 Jul 16;327(3):151-6
1608406
Arch Med Sci. 2010 Jun 30;6(3):420-9
22371781
Pol Arch Med Wewn. 1994 Apr;91(4):247-56
8072884
Pediatr Res. 1996 Sep;40(3):381-7
8865272
Arch Intern Med. 2001 Jan 22;161(2):264-71
11176742
Am J Kidney Dis. 2007 Sep;50(3):471-530
17720528
Medicina (Kaunas). 2003;39 Suppl 1:131-8
12761435
Life Sci. 1979 Jan 29;24(5):433-8
107387
Kidney Int Suppl. 1983 Apr;(13):S19-25
6345894
Med Pregl. 2015 Sep-Oct;68(9-10):324-30
26727829
Kidney Int. 1996 Aug;50(2):550-6
8840285
Blood Purif. 2000;18(2):138-43
10838473
Med Pregl. 2001 May-Jun;54(5-6):235-40
11759218
Am J Med. 2002 Nov;113(7):563-8
12459402
JAMA. 1996 Apr 17;275(15):1177-81
8609685
J Am Coll Nutr. 1999 Apr;18(2):166-70
10204833
Toxicology. 2002 Oct 30;180(1):33-44
12324198
Am J Kidney Dis. 2013 Jan;61(1):44-56
22921639
JAMA. 1999 Jun 23-30;281(24):2289-93
10386552
Environ Health Perspect. 2006 Oct;114(10):1538-41
17035139
Prog Neuropsychopharmacol Biol Psychiatry. 2005 Jul;29(6):922-7
15972243
Arch Environ Health. 1991 Nov-Dec;46(6):347-50
1772259
Nephrology (Carlton). 2009 Aug;14 (5):476-81
19674316
Iran J Basic Med Sci. 2013 Dec;16(12):1209-16
24570825