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

AX6-116
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. (2002)
Study location and
date not provided;
authors from Taiwan
84 healthy participants.
27 participants with gout.
All with normal renal function (defined as serum
creatinine ≤1.4 mg/dL).
Participants with a history of occupational heavy metal
exposure, EDTA-chelatable Pb levels >600 μg/72 hrs, or
systemic diseases were excluded.
Randomized chelation trial
24 participants with EDTA-chelatable Pb levels between
75 and 600 μg/72 hrs randomized to either a treatment
group receiving 1 gram EDTA iv per wk for 4 wks
(N = 12) or to a control group who received glucose in
normal saline i.v.
Multiple linear regression, adjustment for age, sex, BMI,
daily protein intake, and creatinine clearance.
Mean blood Pb
3.9 µg/dL (controls)
4.2 µg/dL (gout)
Mean EDTA-chelatable Pb
45 µg/72 hrs (controls)
84 µg/72 hrs (gout)
(p < 0.0001)
Significantly higher mean EDTA-chelatable Pb and
lower urate clearance were present in patients with
gout compared to those without (3.7 vs. 6.0 mL/min
/1.73 m 2 ; p < 0.001 for urate clearance).
After adjustment, EDTA-chelatable Pb associated
with all four uric acid measures (serum urate, daily
urate excretion, urate clearance, and fractional urate
excretion). Blood Pb associated with serum urate.
All associations in same direction as in Lin et al.
(2001).
Randomized chelation trial.
The two groups had similar urate, renal function, and
Pb measures pre-chelation. In the treated group, mean
blood and EDTA-chelatable Pb levels declined (from
5.0 to 3.7 μg/dL and 110 to 46 μg/72 hrs,
respectively). Statistically significant improvement
observed in all four urate measures in the treated
group compared to the control group.