Elevated lead burden in Chinese patients without occupational lead exposure

Area of Science:

• Nephrology
• Environmental Health
• Toxicology

Background:

• Chronic renal failure (CRF) and gout are significant health concerns.
• The role of environmental toxins, specifically lead, in CRF and gout pathogenesis is not fully understood.
• Occult lead exposure may be an underdiagnosed factor in renal disease.

Purpose of the Study:

• To assess total body lead burden in patients with chronic renal failure and gout.
• To investigate the association between lead exposure and the development of gout in patients with CRF.
• To determine if environmental lead exposure contributes to chronic renal disease in the studied population.

Main Methods:

• Utilized the EDTA (calcium disodium EDTA) mobilization test to measure total body lead burden.
• Collected 72-hour urine samples after EDTA infusion for lead excretion analysis.
• Compared lead excretion levels in healthy controls, patients with CRF, and patients with CRF complicated by gout.

Main Results:

• Healthy Chinese controls exhibited higher urinary lead excretion than reported for German controls.
• The EDTA test identified occult plumbism in 2 patients with CRF but without gout.
• Four out of six CRF patients who developed gout showed evidence of underlying plumbism.

Conclusions:

• A high prevalence of increased lead body burden exists in patients with CRF, particularly those with gout.
• Lead exposure may be a significant contributing factor to chronic renal disease and gout development in this population.
• Chronic low-level environmental lead exposure may subtly impair renal function.