Air Quality Criteria for Lead Volume II of II - (NEPIS)(EPA) - US ...

AX6-106
Table AX6-4.3 (cont’d). Renal Effects of Lead in the Patient Population
Reference, Study
Location, and
Period Study Description Pb Measurement Findings, Interpretation
Europe (cont’d)
Fontanellas et al.
(2002)
Spain
Study date not
provided
Jones et al. (1990)
Study location and
date not provided;
authors from UK
Koster et al. (1989)
Study location and
date not provided;
authors from
Germany
ALAD/restored ALAD as a possible index of Pb poisoning
in chronic renal failure patients.
27 dialysis patients.
59 healthy controls.
91 patients with CRI (median serum creatinine =
2.5 mg/dL).
46 age-matched normal controls.
Pb excretion in the 4 days after
1 g EDTA iv.
Mean blood Pb
8.1 µg/dL (patients)
10.0 µg/dL (controls)
Mean blood Pb
(corrected for hemoglobin)
11.2 µg/dL (patients)
7.6 µg/dL (controls)
Mean EDTA chelatable Pb
164.7 µg/4 days /1.73 m²
(patients)
63.6 µg/4 days /1.73 m²
(controls)
Restored ALAD was measured after the addition of
zinc and dithiothreitol (DTT) to the incubation
media.
The ALAD/restored ALAD ratio was found to
correlate with the results of the EDTA Pb
mobilization test. Patients excreting I,115 to
3860 µg Pb per 72 hrs had a ratio of 0.19 while
chronic renal failure patients excreting an avg of
322 µg Pb (range 195 to 393) had a ratio of 0.47.
In comparison, normal controls had a ratio of 0.5.
Tibia Pb levels not correlated with blood Pb but were
correlated with Pb in bone biopsy measurements
(r = 0.42).
Limitations = data analysis.
CRI patients had significantly higher blood and
EDTA chelatable Pb levels than controls. In 13% of
the CRI patients, EDTA chelatable Pb exceeded the
highest value in controls (328.8 µg). EDTA
chelatable Pb levels were correlated with serum
creatinine in patients (r = 0.37; p < 0.007).
Limitations = data analysis.