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Associations Between Individual and Combined Metal Exposures in Whole Blood and Kidney Function in U.S. Adults Aged 40 Years and Older

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Abstract

The effects of metal exposure on kidney function have been reported in previous literature. There is limited and inconsistent information on the associations between individual and combined exposures to metals and kidney function among the middle-aged and older population. The aim of this study was to clarify the associations of exposure to individual metals with kidney function while accounting for potential coexposure to metal mixtures and to evaluate the joint and interactive associations of blood metals with kidney function. A total of 1669 adults aged 40 years and older were enrolled in the present cross-sectional study using the 2015–2016 National Health and Nutrition Examination Survey (NHANES). Single-metal and multimetal multivariable logistic regression models, quantile G-computation, and Bayesian kernel machine regression models (BKMR) were fitted to explore the individual and joint associations of whole blood metals [lead (Pb), cadmium (Cd), mercury (Hg), cobalt (Co), manganese (Mn), and selenium (Se)] with the odds of decreased estimated glomerular filtration rate (eGFR) and albuminuria. A decreased eGFR was defined as an eGFR ≤ 60 mL/min per 1.73 m2, and albuminuria was categorized as a urinary albumin-creatinine ratio (UACR) of ≥ 30.0 mg/g. The results from quantile G-computation and BKMR indicated positive associations between exposure to the metal mixture and the prevalence of decreased eGFR and albuminuria (all P values < 0.05). These positive associations were mainly driven by blood Co, Cd, and Pb. Furthermore, blood Mn was identified as an influential element contributing to an inverse correlation with kidney dysfunction within metal mixtures. Increasing blood Se levels were negatively associated with the prevalence of decreased eGFR and positively associated with albuminuria. In addition, a potential pairwise interaction between Mn-Co on decreased eGFR was identified by BKMR analysis. Findings from our study suggested a positive association between exposure to the whole blood metal mixture and decreased kidney function, with blood Co, Pb, and Cd being the main contributors to this association, while Mn demonstrated an inverse relationship with renal dysfunction. However, as our study was cross-sectional in nature, further prospective studies are warranted to better understand the individual and combined effects of metals on kidney function.

Highlights

• Exposure to metal mixtures of cadmium (Cd), lead (Pb), mercury (Hg), manganese (Mn), cobalt (Co), and selenium (Se) positively associated with kidney dysfunction.

• Co, Cd, Pb positively associated with kidney function impairment, Mn negatively associated with kidney function impairment.

• A potential pairwise interaction between blood Mn-Co on decreased eGFR may exist.

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Data Availability

The datasets were publicly available from the NHANES Web site (https://www.cdc.gov/nchs/nhanes/index.htm).

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Funding

This work was supported by the National Natural Science Foundation of China [Grant no. 81673248] and the Scientific Research and Innovation Foundation of Gansu University of Chinese Medicine [Grant no. 2022KCYB-11].

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Authors and Affiliations

  1. Gansu University of Chinese Medicine, Lanzhou, 730000, China

    Yaxing Nan, Jinyu Yang & Lili Wei

  2. College of Earth and Environmental Sciences, Lanzhou University, Dong Gang Xi Road 199, Lanzhou, Gansu, 730000, China

    Yaxing Nan, Jingli Yang & Yana Bai

  3. Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 730000, Lanzhou, China

    Yana Bai

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Yaxing Nan: Conceptualization, Methodology, Formal analysis, Visualization, Manuscript writing, Funding acquisition. Jingli Yang: Conceptualization, Methodology, Data curation, Writing-review and editing. Jinyu Yang: Conceptualization, Writing-review and editing, Supervision. Lili Wei: Formal analysis, Data curation. Yana Bai: Data Curation, Conceptualization, Supervision, Validation, Writing—review and editing, Funding acquisition. All authors have read and agreed to the published version of the manuscript.

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Nan, Y., Yang, J., Yang, J. et al. Associations Between Individual and Combined Metal Exposures in Whole Blood and Kidney Function in U.S. Adults Aged 40 Years and Older. Biol Trace Elem Res 202, 850–865 (2024). https://doi.org/10.1007/s12011-023-03722-z

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