Bone lead measurements in patients with chronic renal disease studied over time

Results of longitudinal studies that involved the measurement of lead by different methodologies are presented for two groups of patients with chronic renal disease. Methodologies for all patients included x-ray fluorescence measurements of finger-bone lead. These measurements were conducted 5 y apart for one group of patients (n = 15). Initial measurements for the other group (n = 15) were supplemented by bone lead levels obtained either from skull at craniotomy or from skull, and sometimes rib, at autopsy. Most subjects also underwent ethylenediaminetetraacetic acid (specifically CaNa2 EDTA) lead-mobilization testing. A correlation between rate of decrease in finger-bone lead and immunoreactive parathormone levels was suggested. Renal patients were compared with age-matched controls, and their bone half-lives did not differ. The data are discussed and related to other results obtained from clinical and nonclinical populations in which trabecular and cortical bones were studied, and our results were consistent with evidence that more rapid turnover of lead occurs in trabecular bone than in cortical bone. No support was found for the hypothesis that patients who undergo renal dialysis accumulate lead in bone.