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Related Experiment Videos

Bone lead in dialysis patients.

F L Van de Vyver1, P C D'Haese, W J Visser

  • 1Department of Nephrology-Hypertension, University of Antwerp, Belgium.

Kidney International
|February 1, 1988
PubMed
Summary
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Bone biopsies accurately reflect body lead stores, with the lead/calcium ratio offering more reproducible results than absolute lead concentration. This method is valuable for assessing lead exposure in various patient groups.

Area of Science:

  • Toxicology
  • Bone Biology
  • Environmental Health

Background:

  • Lead exposure is a significant public health concern.
  • Bone is a primary reservoir for lead in the human body.
  • Accurate assessment of body lead burden is crucial for clinical management.

Purpose of the Study:

  • To evaluate the reproducibility and validity of bone biopsies for measuring lead burden.
  • To compare lead/calcium ratios with absolute lead concentrations in bone.
  • To assess the relationship between bone lead levels and body lead stores estimated by EDTA chelation tests.

Main Methods:

  • Analysis of lead and calcium in multiple bone biopsies (iliac crest, transiliac, tibial) from cadavers.
  • Examination of transiliac bone biopsies from patients with renal failure, gout, hypertension, and lead workers.

Related Experiment Videos

  • Correlation of bone lead/calcium ratios with EDTA chelation test results.
  • Histomorphometric analysis of bone biopsies from dialysis patients.

    • Main Results:

    • The lead/calcium ratio in bone biopsy specimens is more reproducible than absolute lead concentration.
    • No significant differences in lead/calcium ratios were found between iliac crest, transiliac, and tibial bone.
    • Bone lead and lead/calcium ratios strongly correlate with body lead stores measured by the EDTA test (r = 0.87 and 0.83).
    • Chronic renal failure and dialysis do not lead to lead accumulation in bone.
    • Elevated bone lead levels did not alter trabecular bone histomorphometry in dialysis patients.
    • Approximately 5% of the studied hemodialysis population had bone lead concentrations similar to active lead workers.

    Conclusions:

    • Transiliac bone biopsies provide a reliable method for assessing cumulative lead exposure.
    • The lead/calcium ratio in bone is a robust biomarker for body lead burden.
    • Bone lead levels in a subset of the hemodialysis population warrant further investigation and potential clinical attention.