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Toxic Metals and Chronic Kidney Disease: a Systematic Review of Recent Literature

  • Metals and Health (A Barchowsky, Section Editor)
  • Published:
Current Environmental Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Arsenic (As), cadmium (Cd), and lead (Pb) are ubiquitous toxicants with evidence of adverse kidney impacts at high exposure levels. There is less evidence whether environmental exposure to As, Cd, or Pb plays a role in development of chronic kidney disease (CKD). We conducted a systematic review to summarize the recent epidemiologic literature examining the relationship between As, Cd, or Pb with CKD.

Recent Findings

We included peer-reviewed studies published in English between January 2013 and April 2018 for As and Cd, and all dates prior to April 2018 for Pb. We imposed temporality requirements for both the definition of CKD (as per NKF-KDOQI guidelines) and environmental exposures prior to disease diagnosis. Our assessment included cohort, case-control or cross-sectional study designs that satisfied 5 inclusion criteria. We included a total of eight articles of which three, two, and four studies examined the effects of As, Cd, or Pb, respectively.

Summary

Studies of As exposure consistently reported positive association with CKD incidence; studies of Pb exposure were mixed. We found little evidence of association between Cd exposure and CKD. Additional well-designed prospective cohort studies are needed and we present recommendations for future studies.

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Abbreviations

As:

Arsenic

BLL:

Blood lead level

BMI:

Body mass index

BP:

Blood pressure

Cd:

Cadmium

eGFR:

estimated Glomerular Filtration Rate

Pb:

Lead

SBP:

Systolic blood pressure

CKDu:

Chronic kidney disease of unknown etiology

ESRD:

End-stage renal disease

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Funding

This work was supported in part by funding from the Mount Sinai Children’s Center Foundation and the NIH (K99ES027508 and T32HD049311).

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Authors and Affiliations

  1. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Emily C. Moody & Alison P. Sanders

  2. Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Steven G. Coca

  3. Departments of Pediatrics & Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA

    Alison P. Sanders

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  1. Emily C. Moody
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Correspondence to Alison P. Sanders.

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Conflict of Interest

Steven Coca reports personal fees from Quark Biopharma, personal fees from Goldfinch Bio, personal fees from Janssen Pharma, personal fees from Renalytix.AI, personal fees from pulseData, outside the submitted work. Emily C. Moody and Alison P. Sanders declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Moody, E.C., Coca, S.G. & Sanders, A.P. Toxic Metals and Chronic Kidney Disease: a Systematic Review of Recent Literature. Curr Envir Health Rpt 5, 453–463 (2018). https://doi.org/10.1007/s40572-018-0212-1

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