Lead, diabetes, hypertension, and renal function: the normative aging study

Area of Science:

• Environmental Health
• Nephrology
• Gerontology

Background:

• Lead exposure is a potential risk factor for chronic kidney disease.
• The impact of lead on renal function decline in aging populations, especially those with comorbidities, requires further investigation.

Purpose of the Study:

• To investigate the association between baseline lead levels and changes in renal function over six years.
• To examine the modifying effects of diabetes and hypertension on the relationship between lead exposure and renal function decline.

Main Methods:

• Prospective cohort study of 448 middle-aged and elderly men.
• Assessed changes in serum creatinine (SCr) over 6 years.
• Measured baseline blood, patella, and tibia lead levels.
• Used multivariate-adjusted regression analyses with interaction terms for diabetes and hypertension.

Main Results:

• Longitudinal increases in SCr were associated with higher baseline lead levels, though not always statistically significant.
• Significant interactions were found between blood/tibia lead and diabetes in predicting SCr change.
• The rate of SCr increase was substantially higher in diabetic individuals with elevated tibia lead levels.
• Tibia lead also interacted with hypertension in predicting SCr change.

Conclusions:

• Long-term lead stores and circulating lead contribute to renal function decline in older adults.
• The detrimental effect of lead on kidney function is significantly amplified in individuals with diabetes and hypertension.
• Diabetics and hypertensives represent particularly susceptible groups to lead-induced nephrotoxicity.