Patterns of lead excretion in patients with gout and chronic renal failure--a comparative German and Australian study

The 6 day calcium EDTA lead excretion test was performed on German and Australian subjects with normal and impaired renal function, some of whom had gout, in order to determine if the pattern of results differed between the two countries. The German subjects lived around Heidelberg in an industrialized area where chronic lead nephropathy had not hitherto been thought to exist, while the Australian subjects were all from the State of Queensland where chronic lead nephropathy from the ingestion of lead paint during childhood continues to contribute to morbidity and mortality. Apart from the subjects with normal renal function, the German subjects consistently excreted less lead than the Queensland subjects and a strikingly consistent pattern was found: in both countries, subjects with a history of lead exposure, whether gouty or not, had greater EDTA lead excess values than subjects with gout but no lead exposure, these subjects in turn having greater EDTA lead excess values than subjects with neither gout nor lead exposure. In each country, the highest median EDTA lead excess occurred not in the group with gout and lead exposure, but in the group without gout and with lead exposure.