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Sanchez-Fructuoso, Torralbo A, Arroyo M, Luque M, Ruilope LM, Santos JL, Cruceyra A, Barrientos A
Occult lead intoxication as a cause of hypertension and renal failure
Nephrol Dial Transplant (Sep) 11:1775-1780 1996
The relationship between occult CRF and lead exposure remains unclear. It has been shown that lead exposure can exacerbate renal diseases due to other causes, but whether occult, unrecognized lead exposure can lead to renal disease has not been shown.
In this study, blood lead levels, EDTA stimulated urinary lead excretion, and in a small number of patients, bone lead levels were measured. There were four groups: I normals, IV patients with CRF of known etiology, II essential hypertensives, III patients with CRF of unknown etiology with hypertension and/or gout. Blood levels were within normal levels in all groups. EDTA tests were normal in groups I and IV, suggesting that CRF per se does not result in lead accumulation. EDTA tests were abnormal in 15% of group II and 56% of group III, and in group III, serum creatinine levels correlated with post EDTA urinary Pb excretion. In 12 patients with abnormal EDTA results, bone Pb correlated with serum creatinine.
Comment: The study is strong evidence of occult lead exposure as a cause of CRF. Firstly, it showed that CRF per se does not cause an abnormal EDTA Pb excretion. In group III, there was a strong relation between body lead burden and creatinine clearance. Where this lead exposure came from was unclear, as none of the patients gave a positive history for this. (John T. Daugirdas, M.D., University of Illinois at Chicago)
The full text of this abstract is available from Oxford Press at this site.
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