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

AX6-108
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)
Sánchez-Fructuoso
et al. (1996)
Spain
Study date not
provided
296 patients:
Group I = 30 normal control subjects
Group II = 104 patients with essential HTN & normal
renal function
Group III-A = 68 patients with HTN and CRI of uncertain
etiology but presumed nephroangiosclerosis
Group III-B = 64 patients with HTN, CRI, and gout
Group IV = 30 patients with CRI of known etiology
Mean blood and EDTAchelatable
Pb levels
Group I
16.7 µg/dL
324 µg/72 hrs
Group II
16.8 µg/dL
487 µg/72 hrs
Group III-A
18.5 µg/dL
678 µg/72 hrs
Group III-B
21.1 µg/dL
1290 µg/72 hrs
Group IV
16.5 µg/dL
321 µg/72 hrs
EDTA chelatable Pb >600 µg/72 hrs in 16 patients in
group II, 30 patients in group III-A, 44 patients in
group III-B, but no patients in either group I and IV.
Mean blood and EDTA chelatable Pb levels in the
patients with CRI of known cause were not
statistically different from controls with normal renal
function. However, baseline urinary Pb excretion was
lower in group IV. This provides conflicting evidence
regarding the “reverse causality” hypothesis of
increased Pb burden due to decreased excretion in
CRI.
Significant correlations noted between bone Pb levels
(assessed by biopsy) and EDTA chelatable Pb level in
12 patients whose chelatable Pb levels were >600
µg/72 hrs; provides support for validity of chelatable
Pb levels in CRI.
A positive correlation was observed between serum
creatinine levels and EDTA-chelatable Pb levels
>600 µg/72 hrs but not below this level.
In group III, mean measured creatinine clearance was
significantly lower in those with EDTA chelatable Pb
levels >600 μg/72 hrs compared to participants with
chelatable Pb