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

AX6-115
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
Asia (cont’d)
Lin et al. (2001b)
Study location and
date not provided;
authors from Taiwan
101 patients with CRI (defined as serum creatinine
between 1.5 and 3.0 mg/dL).
67 with CRI and gout.
34 with CRI only.
Eligibility criteria included no known history of Pb
exposure, certain diagnoses, and medications. CRI must
have preceded gout diagnosis.
Randomized chelation trial
30 participants with CRI, gout, and EDTA-chelatable Pb
levels between 80.2 and 361 μg/72 hrs randomized to
either a treatment group receiving 1 gram EDTA iv per wk
for 4 wks (N = 20) or to a control group who received
glucose in normal saline iv.
Mean blood Pb
5.4 µg/dL (CRI and gout)
4.4 µg/dL (CRI only)
Mean EDTA-chelatable Pb
138.1 µg/72 hrs (CRI and
gout)
64.2 µg/72 hrs (CRI only)
(p < 0.01)
In 101, EDTA-chelatable Pb higher in patients with
CRI and gout compared to those with CRI only.
EDTA-chelatable Pb, but not blood Pb, was
associated positively with serum urate and negatively
with daily urate excretion, urate clearance, and
fractional urate excretion.
Randomized chelation trial
The two groups had similar uric acid, renal function,
and Pb measures pre-chelation. In the treated group,
mean EDTA-chelatable Pb declined from 159.2 to
41 μg/72 hrs; mean serum urate decreased from 10.2
to 8.6 mg/dL (% change compared to the control
group = !22.4 [95% CI: !46.0, !1.5]; p = 0.02), and
mean urate clearance increased from 2.7 to
4.2 mL/min (% change compared to the control group
= 67.9 [95% CI: 12.2, 121.2]; p < 0.01). Daily and
fractional urate excretion were also significantly
different between the two groups. Mean measured
creatinine clearance increased from 50.8 to
54.2 mL/min (% change compared to the control
group = 8.0 [95% CI: !0.4, 20.1]; p = 0.06).