Environmental Lead Exposure

Many may remember the NEJM article proving that patients with early renal impairment could often avoid renal dialysis if they routinely were maintained on CALCIUM EDTA infusions. Now there is new research finding that low levels of lead from the environment are adversely affecting renal function. By now, hopefully, all of you are aware that Lead levels have been tied to all causes of morbidity and mortality. However, remember the SYNERGISTIC toxicity effects where small amounts of other toxic metals like Mercury dramatically enhance the adverse effect of Lead.

Unfortunately NO test seems to be as accurate as BONE LEAD in determining risks of cataracts or heart attacks. But since we know we are all toxic today, this is just another indicator that may lead a few more patients to take preventive steps with a program using oral or parenteral chelators and or Zeolite, or even high dose oral vitamin c.  Renal dialysis is not fun and kidney transplants are not easy to come by.

Garry F. Gordon MD,DO,MD(H)
President, Gordon Research Institute
www.gordonresearch.com

http://www.medscape.com/viewarticle/715046

From Medscape Medical News

Low-Level Environmental Lead Exposure May Adversely Affect Renal Function
Laurie Barclay, MD

January 13, 2010 — Low-level environmental lead exposure may adversely affect renal function, according to results from the Third National Health and Nutrition Examination Survey, reported in the January 11 issue of the Archives of Internal Medicine.

“Chronic, high-level lead exposure is a known risk factor for kidney disease,” write Jeffrey J. Fadrowski, MD, MHS, from Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, and colleagues. “The effect of current low-level environmental lead exposure is less well known, particularly among children, a population generally free from kidney disease risk factors such as hypertension and diabetes mellitus. Therefore, in this study, we investigated the association between lead exposure and kidney function in a representative sample of US adolescents.”

The study cohort consisted of 769 adolescents aged 12 to 20 years for whom whole blood lead and serum cystatin C were measured in the Third National Health and Nutrition Examination Survey, which took place from 1988 to 1994. The investigators evaluated the association between blood lead level and level of kidney function, reflected in glomerular filtration rate (GFR) calculated from cystatin C–based and creatinine-based estimating equations.

Median whole blood lead level was 1.5 μg/dL (to convert to micromoles per liter, multiply by 0.0483), and median cystatin C–estimated GFR was 112.9 mL/min/1.73 m2. Compared with participants in the first quartile of lead levels (<1 μg/dL), those with lead levels in the highest quartile (≥3.0 μg/dL) had a lower estimated GFR by 6.6 mL/min/1.73 m2 (95% confidence interval [CI], −0.7 to −12.6 mL/min/1.73 m2). Twofold increase in blood lead level was associated with lower estimated GFR by 2.9 mL/min/1.73 m2 (95% CI, −0.7 to −5.0 mL/min/1.73 m2). Although lead levels were also associated with lower creatinine-based estimated GFR levels, t