Lead nephropathy

  • Richard P. Wedeen
Chapter

Occupational exposure to lead originated over 10,000 years ago in the region of the Aegean sea. The earliest description of lead poisoning is a poem dating from about 200 BC by the Greek philosopher Nikander of Colophon [1]. Although possible recognition of renal effects of lead can be traced to the 17th century, Lancereaux provided the first description of lead nephrotoxicity in modern terms in 1862. Lancereaux’s patient had saturnine (lead-induced) gout; his kidneys showed interstitial nephritis at postmortem examination [2]. Controversy concerning the renal effects of lead stems from this 19th century description compounded by the recurrent difficulty in recognizing the late sequelae of chronic absorption of relatively low levels of lead. Early reports failed to distinguish glomerular from extraglomerular renal disease. Additional confusion has been created by the failure to distinguish the transient Fanconi syndrome of acute symptomatic lead poisoning from the insidious chronic interstitial nephritis characteristic of lead nephropathy in adults.

In addition to the difficulty in assigning cause when the effect is delayed in time, identification of the renal effects of lead was further obscured because the late complications of excessive lead absorption, namely, gout and hypertension, can themselves produce renal damage unrelated to lead. The kidney has permissive control of blood pressure by modulating fluid volume and more direct control by intrarenal hormones which effect vascular tone. Hypertension and kidney disease are therefore inextricably interrelated.

Keywords

Glomerular Filtration Rate Blood Lead Level Interstitial Nephritis Lead Poisoning Chelation Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Wedeen RP. Poison in the Pot: the Legacy of Lead. Carbondale, Ill: Southern Illinois University Press, 1984.Google Scholar
  2. 2.
    Lancereaux E. Saturnisme chronique avec acces de goutte et Arthritis uratiques. Compt Rend Soc de Biol (Paris) 1872; 2: 99-106.Google Scholar
  3. 3.
    Rabinowitz MB. Kinetic analysis of lead metabolism in healthy humans. J Clin Invest 1976; 58: 260-270.CrossRefPubMedGoogle Scholar
  4. 4.
    Wedeen RP, Maesaka JK, Weiner B, Lipat GA, Lyons MM, Vitale LF. Joselow MM. Occupational lead nephropathy. Am J Med 1975; 59: 630-641.CrossRefPubMedGoogle Scholar
  5. 5.
    Menke A, Munter P, Batuman V, Silbergeld EK, Guallar E. Blood lead below 0.48 βmol/L (10 ug/dL) and mortality among US adults. Circulation 2006; 114: 1388-1394.CrossRefPubMedGoogle Scholar
  6. 6.
    Sanchez-Fructuoso AI, Torralbo A, Arroyo M, Luque,\ M, Ruilope LM, Santos JL, Cruycyera A, Barrientes A. Occult lead intoxication as a cause of hypertension and renal failure. Nephrol Dial Transplant 1996; 11:1775-178.PubMedGoogle Scholar
  7. 7.
    Van de Vyver FL, D’Haese PC, Visier WJ, Elseviers MM, Knippenberg LI, Lamberts LW, Wedeen, RP, De Broe ME. Bone lead in dialysis patients. Kidney Int 1988; 33: 601-607.CrossRefPubMedGoogle Scholar
  8. 8.
    Inglis JA, Henderson DA, Emmerson BT. The pathology and pathogenesis of chronic lead nephropathy occurring in Queensland. J Path 1978; 124: 65-76.CrossRefPubMedGoogle Scholar
  9. 9.
    Grandjean P. Biological effects of organolead compounds. Boca Raton, FL: CRC Press, 1984.Google Scholar
  10. 10.
    Wedeen RP. The politics of lead. In: Sheehan HE, Wedeen RP, eds. Toxic circles: environmental hazards from the workplace into community. New Brunswick: Rutgers University, 1993:168-200.Google Scholar
  11. 11.
    Fiedler, N., Weisel, C., Lynch, R., Kelly-McNeil, K., Wedeen, R., Jones, K., Udasin, I., Ohman-Strickland, P., and Gochfeld, M. Cognitive effects of chronic exposure to lead and solvents. Am. J. Indust. Med. 2003; 4: 413-423.CrossRefGoogle Scholar
  12. 12.
    Glenn BS, Stewart WF, Links JM, Todd AC, Schwartz BS. The longitudinal association of lead and blood pressure. Epidemiology 2003; 14: 30-36.CrossRefPubMedGoogle Scholar
  13. 13.
    Chisolm JJ, Harrison HC, Eberlern WR, Harrison HE. Aminoaciduria, hypophosphatemia and rickets in lead poisoning. Am J Dis Child 1955; 89: 159-68.Google Scholar
  14. 14.
    Goyer RA, Wilson MH. Lead-induced inclusion bodies. Results of ethylenediaminetetraacetic acid treatment. Lab Invest 1975; 32: 149-56.PubMedGoogle Scholar
  15. 15.
    Schumann GB, Lerner SI, Weiss MA, Gawronski L, Lohiya GK. Inclusion-bearing cells in industrial workers exposed to lead. Am J Clin Pathol 1980; 74: 192-6.PubMedGoogle Scholar
  16. 16.
    Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C, Klag MJ. Prevelence of high blood pressure and elevated serum creatinine level in the United States. 2001; 161; 1206-1216.Google Scholar
  17. 17.
    Selevan SG, Landrigan PJ, Stern FB, Jones JH. Mortality of lead smelter workers. Am J Epidemiol 1985; 122: 673-83.PubMedGoogle Scholar
  18. 18.
    Emmerson BT. Chronic lead nephropathy. The diagnostic use of calcium EDTA and the association with gout. Aust Med J 1963; 12: 310-324.Google Scholar
  19. 19.
    Wedeen RP, Mallik DK, Batuman V, Bogden JD. Geophagic lead nephropathy: A case report. Environ Res 1978; 17: 409-415.CrossRefPubMedGoogle Scholar
  20. 20.
    Wedeen RP, Mallik DK, Batuman V. Detection and treatment of occupational lead nephropathy. Arch Intern Med 1979; 139: 53-57.CrossRefPubMedGoogle Scholar
  21. 21.
    Batuman, V., Maesaka, J.K., Haddad, B., Tepper, E., Landy, E. and Wedeen, R.P. The role of lead in gout nephropathy. N. Engl. J. Med. 1981; 304: 520 523.PubMedGoogle Scholar
  22. 22.
    Batuman V, Landy E, Maesaka JK, Wedeen RP. Contribution of lead to hypertension with renal failure. N Engl J Med 1983; 309: 17-21.PubMedGoogle Scholar
  23. 23.
    Colleoni N, D’Aminco G. Chronic lead accumulation as a possible cause of renal failure in gouty patients. Nephron 1986: 44; 32-35.CrossRefPubMedGoogle Scholar
  24. 24.
    Behringer D, Craswell P., Mohl C. Stoeppler M, Tritz E. Urinary lead excretion in uremic patients. Nephron 1986: 42 323-329.CrossRefPubMedGoogle Scholar
  25. 25.
    Lin J-A, Ho H-H, Yu C-C. Chelation therapy for patients with elevated body lead burden and progressive renal insufficiency. A randomized controlled trial. Ann Intern Med 1999; 130:7-13.PubMedGoogle Scholar
  26. 26.
    Tepper L. Renal function subsequent to childhood plumbism. Arch Environ Health 1963; 7: 76-85.PubMedGoogle Scholar
  27. 27.
    Hu H. A 50-year follow-up of childhood plumbism: hypertension, renal function, and hemoglobin levels among survivors. Am J Dis Child 1991; 145:681-687.PubMedGoogle Scholar
  28. 28.
    Lilis R, Garvrilescu N, Nestroescu R, Dumitriu C, Roventa A. Nephropathy in chronic lead poisoning. Br J Ind Med 1968;25:196-202.PubMedGoogle Scholar
  29. 29.
    Martin D, Glass TA, Bandeen-Roche K, Todd AC, Shi W, Schwartz BS. Association of blood lead and tibia lead with blood pressure and hypertension in a community sample of older adults. Am J Epidemiol 2006; 163: 467-478.CrossRefPubMedGoogle Scholar
  30. 30.
    Chai S S, Webb RC. Effects of lead on vascular reactivity. Environ Health Perspect 1988; 78: 85-91.CrossRefPubMedGoogle Scholar
  31. 31.
    Steenland NK, Thun Mj, Furguson W, Port FK. Occupational and other exposures associated with male end stage renal disease:a case/control study. Am J Public Health 1990; 80: 153-159.CrossRefPubMedGoogle Scholar
  32. 32.
    Kopp SJ, Barron JT, Tow JP. Cardiovascular actions of lead and relationship to hypertension: a review. Scand J Work Environ Health 1985; 11: 15-23.Google Scholar
  33. 33.
    Cardenas A, Roels H, Bernard AM, Barbon R, Buchet JP, Lauwerys RR, Rosello J, Ramis I, Mutti A, Franchini I, Fels LM, Stolte H, De Broe ME, Nuyts GD, Taylor SA, Price RG. Markers of early renal changes induced by industrial pollutants. II. Application to workers exposed to lead. Brit J Ind Med 1993; 50: 28-36.Google Scholar
  34. 34.
    Mueller PW, Paschal PC, Hammel RR, Klincewitz SL, McNeil ML, Speirto B, Steinberg KK. Chronic effects in three studies of men and women occupationally exposed to cadmium. Arch Environ Contam Toxicol 1992; 23: 125-136.CrossRefPubMedGoogle Scholar
  35. 35.
    Endo G, Horiguchi S, Kiyota I. Urinary N-acetyl-ß-D-glucosaminidase activity in lead-exposed workers. J Appl Toxicol 1990; 10: 235-238.CrossRefPubMedGoogle Scholar
  36. 36.
    Wedeen RP, Udasin I., Fiedler N, D’Haese P, De Broe ME, Gelpi E, Jones KW, Gochfeld M. Urinary biomarkers as indicators of renal disease. Renal Failure. 1999; 21: 241-249.CrossRefPubMedGoogle Scholar
  37. 37.
    Peitzman SJ, Bodison W, Ellis I. Moonshine drinking among hypertensive veterans in Philadelphia. Arch Intern Med 1985; 145: 632-634.CrossRefPubMedGoogle Scholar
  38. 38.
    Nakagawat, Kang D-H, Sanchez-Lozada LG, Srinivas TR, Sautin Y, Ejaz AA, Segal M, Johnson RJ. Unearthing uric acid: An ancient factor with recently found significance in renal cardiovascular disease. Kidney International 2006; 69:1722-1735.CrossRefGoogle Scholar
  39. 39.
    Vaziri ND, Sica DA. Lead-induced hypertension: Role of oxidative stress. Curreent Hypertension Reports 2004; 6: 314-320.CrossRefGoogle Scholar
  40. 40.
    Staessen J, Lauwerys RR, Buchet J-P, Bulpitt CJ, Rondia D, Vanenterghem Y, Amery A. Impairment of renal function with increasing blood lead concentration in the general population. The Cadmibel study group. N Engl J Med 1994; 327: 151-156.Google Scholar
  41. 41.
    Mahaffey KR, Annest JL, Roberts J, Murphy RS. National estimates of blood lead levels: United States, 1976-1980. Association with selected demographic and socioeconomic factors. N Engl J Med 1982; 307: 573-579.PubMedGoogle Scholar
  42. 42.
    Harlan WR. The relationship of blood lead levels to blood pressure in the U.S. population. Environ Health Perspect 1988; 78: 9-13.CrossRefPubMedGoogle Scholar
  43. 43.
    Pirkle JL, Schwartz J, Landia JR, Harlan WR. The relationship between blood lead levels and blood pressure and its cardiovascular risk implications. Am J Epidemiol 1985; 121: 246-258.PubMedGoogle Scholar
  44. 44.
    Munter P, He J, Vupputuri S, Coresh J, Batuman V. Blood lead and chronic kidney disease in the general United States population:Results from NHANES III. Kidney Int 2003; 63: 1044-1050.CrossRefGoogle Scholar
  45. 45.
    Payton M, Hu H, Sparrow D, Young JB, Landsberg L, Weiss S. Relation between blood lead and urinary biogenic amines in com-munity-exposed men. Am J Epidemiology. 1993; 138(10): 815-825.Google Scholar
  46. 46.
    Lustberg M, Silbergeld E. Blood lead levels and mortality. Arch Intern Med 2002; 162: 2443-2449.CrossRefPubMedGoogle Scholar
  47. 47.
    Munter P, Menke A, DeSalvo KB, Rabito FA, Batuman V. Continued decline in blood lead levels among adults in the United States. Arch Intern Med 2006; 165: 2155-2161.CrossRefGoogle Scholar
  48. 48.
    Kim R, Rotnitski A, Parrow D, Weiss ST, Wager C, Hu H A longitudinal study of low-level lead exposure and impairment of renal function. The Normative Aging Study. JAMA 1996; 275: 1177-1176.CrossRefPubMedGoogle Scholar
  49. 49.
    Hu H, Aro A, Payton M, Korrick S, Sparrow D, Weiss ST. The relationship of bone and blood lead to hypertension. The Normative Aging Study. JAMA 1996; 275: 1171-1176.CrossRefPubMedGoogle Scholar
  50. 50.
    Thais S-W, Korrick S, Schwartz J, Amasirlwardena C, Aro A, Sparrow D, Hu H. Lead diabetes, hypertension, and renal function: Normative Aging Study. Environ Health Perspect 2004; 112: 1178-1182.Google Scholar
  51. 51.
    Cheng Y, Schwartz J, Sparrow D, Aro A, Weiss, ST, Hu H. Bone lead and bone lead levels in relation to baseline blood pressure and the prospective development of hypertension: The Normative Aging Study. Am J Epidemiology. 2001; 153(2): 164-171.CrossRefGoogle Scholar
  52. 52.
    Korrick SA, Hunter DJ, Rotnitzky A, Hu H, Speizer FE. Lead and hypertension in a sample of middle-aged women. Am J Public Health. 1999; 89(3): 330-335.CrossRefPubMedGoogle Scholar
  53. 53.
    Vupputuri S, He J, Munter P, Bazzano LA, Whelton PK, Batuman V. Blood lead level is associated with elevated blood pressure in blacks. Hypertension 2003; 41: 463-468.CrossRefPubMedGoogle Scholar
  54. 54.
    Byung-Kook L, Lee G-S, Stewert WF, Kyu-Dong A, Simon D, Kelsey KT, Todd AC, Schwartz BS. Associations of blood pressure and hypertension with lead dose measures and polymorphisms in the vitamin D receptor and β-aminolevulinic acid dehydratase genes. Environ Health Perspectives 2001; 109: 383-389.CrossRefGoogle Scholar
  55. 55.
    Elmarsafawy SF, Nitin J, Schwartz J, Sparrow D, Nie H, Hu H. Dietary calcium as a potential modifier of the relationship between lead burden to blood pressure. Epidemiology 2006; 17(5): 531-7.CrossRefPubMedGoogle Scholar
  56. 56.
    Rothenberg S, Khondrashov V, Manalo M, Jiang J, Cuellar R, Garcia M, et al. Increases in hypertension and blood pressure during pregnancy with increased bone lead levels. Am J Epidemiology 2002; 156(12):1079-1087CrossRefGoogle Scholar
  57. 57.
    Vigeh M, Ghazizadeh S, Yokayama K, Sakai T, Mazaheri M, Morita Y, Beheshti S, Kitamura F, Araki S. Relationship between increased blood lead and preganacy hypertension in women without occupational lead exposure in Tehran, Iran. Arch Environ Health 2004; 59: 70-75.CrossRefPubMedGoogle Scholar
  58. 58.
    Ekong EB, Jaar BJ, Weaver VM. Lead-related nephrotoxicity: A review of the epidemiologic evidence. Kidney Int 2006; 70: 2074-2084.PubMedGoogle Scholar
  59. 59.
    Legator MS, Morris DL. What did Sir Bradford Hill really say? Arch Environ Health 2003; 58: 718-720.PubMedGoogle Scholar
  60. 60.
    Wedeen RP. Blood lead levels, dietary calcium, and hypertension. Ann Intern Med 1985; 102:403.PubMedGoogle Scholar
  61. 61.
    Lin J-L, Lin-Tan D-T, Yu C-C, Li Y-J, Huang Y-Y, li K-L. Environmental exposure to lead and progressive diabetic nephropathy in patients with type II diabetes. Kidney International 2006; 69: 2049-2056.CrossRefPubMedGoogle Scholar
  62. 62.
    Lin J-L, Lin-Tan D-T, Hsu K-H, Yu C-C. Environmental lead exposure and progression of chronic renal diseases in patients without diabetes. N Eng J Med 2003; 348: 277-286.CrossRefGoogle Scholar
  63. 63.
    Sehnert KW, Claque AF, Cheraskin E. The improvement in renal function following EDTA chelation and multi-vitamin-trace mineral therapy: a study in creatinine clearance. Med Hypoth 1984; 15: 301-304.CrossRefGoogle Scholar
  64. 64.
    Germain MJ, Braden GL, Fitzgibbons JP. Failure of chelation therapy in lead nephropathy. Arch Intern Med 1984; 144: 2419-2420.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Richard P. Wedeen
    • 1
  1. 1.Department of Veterans Affairs New Jersey Health Care SystemEast OrangeUSA

Personalised recommendations