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

AX6-122
Table AX6-4.5. Renal Effects of Lead in Children
Reference, Study
Location, and Period Study Description Pb Measurement Findings, Interpretation
United States
Hu (1991)
U.S.
Study date not
provided
Loghman-Adham
(1998)
Chicago, IL
Study date not
provided
21 of 192 adults who were hospitalized at Boston
Children’s Hospital between 1932 to 1942 for childhood
Pb poisoning were traced to a Boston area address.
Matched on age, sex, race, and neighborhood to
21controls.
134 children and young adults, 8 to 13 yrs after chelation
therapy for severe Pb poisoning.
Mean age at poisoning = 2.3 yrs
Mean age at follow-up = 13.4 yrs
Mean (SD) blood Pb
6.0 µg/dL (Pb poisoned)
7.5 µg/dL (controls)
Mean peak blood Pb level
121 µg/dL
Mean blood Pb level at time
of study
18.6 µg/dL
No significant differences in blood Pb level, serum
creatinine, or BUN. Mean measured creatinine
clearance higher in the previously Pb poisoned group
compared to controls (112.8 vs. 88.8 mL/min/1.73 m 2
[p < 0.01]). Mean in the Pb exposed group was also
higher than the predicted value of 94.2 mL/min/1.73
m 2 from the nomogram of Rowe et al. (1976).
Suggests Pb-related hyperfiltration. As noted in
section 6.4, one survivor, identified but not included
in the study, had disease consistent with Pb
nephropathy.
Limitations = small study size and concern for
survivor bias in the study group.
Mean serum creatinine was normal (0.8 mg/dL).
Calculated creatinine clearance normal in all but 3
children. No correlation between either initial or
current blood Pb and serum creatinine or calculated
creatinine clearance.
Urinary α-amino nitrogen concentrations were
significantly increased compared with 19 healthy age
matched controls and were correlated with current
blood Pb levels. Thirty-two children (24%) had
glycosuria. Fractional excretion of phosphate,
however, was normal in all children. The author
concluded that a partial Fanconi syndrome could
persist for up to 13 yrs after childhood Pb poisoning.
The author notes that the prognostic significance of
this is unknown at present.