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

AX6-111
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
Australia (cont’d)
Price et al. (1992)
Queensland,
Australia
1981-1986
Asia
Lin and Lim (1992)
Chinese population
(likely in Taiwan)
Study date not
provided
Lin and Huang
(1994)
Taiwan
Study date not
provided
8 renal patients compared with age-matched controls.
X-ray fluorescence of finger bone Pb conducted twice 5
yrs apart.
10 healthy controls.
10 patients with CRI but no gout.
8 patients with gout and subsequent CRI.
6 patients with CRI and subsequent gout.
Exclusionary criteria included + history of occupational or
environmental Pb exposure.
Group 1 = 10 patients with normal renal function and no
gout; Group 2 = 10 patients with CRI (serum creatinine
>1.4 mg/dL) and subsequent gout; Group 3 = 20 patients
with CRI but no gout.
All males.
Pb body burden assessed with 1 g EDTA iv followed by
72 hr urine collection.
Mean EDTA chelatable Pb in
µg/72 hrs/1.73 m 2
90.2 (controls)
98 (CRI, no gout)
171.6 (gout, then CRI)
359.8 (CRI, then gout)
Mean EDTA chelatable Pb
Gp 1 = 60.55 µg/ 72 hrs
Gp 2 = 252.24 µg/ 72 hrs
Gp 3 = 84.86 µg/ 72 hrs
Authors conclude that Pb in bone half-life is similar in
renal patients compared to age-matched controls.
Study limitations substantial, however.
Limitations = small numbers (although bone Pb
measured in more patients, many were below the limit
of detection, inclusion of outliers without formal
statistical analysis.
Pb body burden higher in patients with CRI and gout,
especially when CRI precedes gout.
Limitations = small sample sizes, statistical analysis.
Mean EDTA chelatable Pb and serum urate
significantly higher in the patients with gout. After
adjustment for creatinine clearance, log transformed
EDTA chelatable Pb was significantly associated with
serum urate levels (∃ = 0.757 [95% CI: 0.142, 1.372];
p < 0.05), daily urate excretion (∃ = !60.15 [95% CI:
!118.1, !2.16]; p < 0.05), urate clearance (∃ = !0.811
[95% CI: !1.34, !0.282]; p < 0.05), and fractional
urate excretion (∃ = !1.535 [95% CI: !2.723, !0.347];
p < 0.05). EDTA chelatable Pb not associated with
creatinine clearance.
Limitations = small sample sizes, limited adjustment
in regression analyses.