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Article Review/Hyperlink
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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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