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High prevalence of elevated lead levels in pediatric dialysis patients

Guido Filler1, Elizabeth Roach, Abeer Yasin

  • 1Department of Pediatrics, Schulich School of Medicine & Dentistry, London, ON, Canada. guido.filler@lhsc.on.ca

Pediatric Nephrology (Berlin, Germany)
|April 25, 2012
PubMed

Insights

Pediatric chronic kidney disease (CKD) patients on calcium carbonate treatment showed elevated blood lead (Pb) levels. Monitoring lead is crucial for these vulnerable patients.

Area of Science:

  • Nephrology
  • Environmental Health
  • Pediatric Medicine

Background:

  • Concerns arose regarding lead (Pb) contamination in calcium carbonate used for hyperphosphatemia treatment in pediatric chronic kidney disease (CKD).
  • A quality-assurance investigation was conducted to measure blood Pb levels in pediatric CKD patients.

Purpose of the Study:

  • To assess blood lead levels in pediatric patients with chronic kidney disease (CKD).
  • To investigate the correlation between lead levels, kidney function, and calcium carbonate dosage.

Main Methods:

  • Blood lead (Pb) levels were measured using high-resolution sector field inductively coupled mass spectrometry.
  • Kidney function was assessed via cystatin C estimated glomerular filtration rate (eGFR).
  • Lead levels in dialysis feed water were also analyzed.

Main Results:

  • Pediatric CKD patients exhibited significantly higher mean blood Pb concentrations (21.1 ± 15.8 µg/l) compared to healthy controls.
  • Elevated lead levels correlated with red blood cell distribution width, eGFR, and calcium carbonate dose.
  • Lead levels in dialysis feed water were below the accepted limit.

Conclusions:

  • A high prevalence of elevated blood lead levels was found in pediatric CKD patients.
  • Lead levels were correlated with calcium carbonate dose and glomerular filtration rate (GFR).
  • Routine monitoring of lead levels is recommended for pediatric CKD patients.
Abstract

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