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Volume 11
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10.3390/diagnostics11020282
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Article

Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

by
Hui-Ju Tsai
1,2,†,
Chih-Hsing Hung
2,3,4,†,
Chih-Wen Wang
5,6,
Hung-Pin Tu
7,
Chiu-Hui Li
8,
Chun-Chi Tsai
8,
Wen-Yi Lin
2,6,8,
Szu-Chia Chen
2,5,9,* and
Chao-Hung Kuo
5,10
1
Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
2
Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
3
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
4
Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
5
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
6
Department of Internal Medicine, Division of Hepatobiliary, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
7
Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
8
Health Management and Occupational Safety Health Center, Kaohsiung Municipal Siaogang Hospital; Kaohsiung 812, Taiwan
9
Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
10
Department of Internal Medicine, Division of Gastroenterology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
*
Author to whom correspondence should be addressed.
†
Both are equal contributors.
Diagnostics 2021, 11(2), 282; https://doi.org/10.3390/diagnostics11020282
Submission received: 12 January 2021 / Revised: 7 February 2021 / Accepted: 8 February 2021 / Published: 11 February 2021
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Abstract

Background: The prevalence of chronic kidney disease (CKD) is increasing annually in Taiwan. In addition to traditional risk factors, heavy metals contribute to the development of CKD. The aim of this study was to investigate associations among heavy metals and proteinuria and CKD in the general population in Southern Taiwan. We also explored the interaction and synergetic effects among heavy metals on proteinuria. Methods: We conducted a health survey in the general population living in Southern Taiwan between June 2016 and September 2018. Seven heavy metals were measured: blood lead (Pb) and urine nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), copper (Cu), and cadmium (Cd). Proteinuria was measured using reagent strips. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Results: The mean age of the 2447 participants was 55.1 ± 13.2 years and included 977 males and 1470 females. Participants with high blood Pb and high urine Ni, Mn, Cu, and Cd were significantly associated with proteinuria. Interactions between blood Pb and urine Cr, and between urine Cd and Cu, had significant effects on proteinuria. The participants with high blood Pb and high urine Cu were significantly associated with an eGFR of <60 mL/min/1.73 m2. Conclusion: High blood Pb and high urine Cu may be associated with proteinuria and an eGFR of <60 mL/min/1.73 m2. High urine Ni, Mn, and Cd were significantly associated with proteinuria. Co-exposure to Cd and Cu, and Pb and Cr, may have synergistic effects on proteinuria.
Keywords: heavy metals; proteinuria; chronic kidney disease; estimated glomerular filtration rate; renal function heavy metals; proteinuria; chronic kidney disease; estimated glomerular filtration rate; renal function

Share and Cite

MDPI and ACS Style

Tsai, H.-J.; Hung, C.-H.; Wang, C.-W.; Tu, H.-P.; Li, C.-H.; Tsai, C.-C.; Lin, W.-Y.; Chen, S.-C.; Kuo, C.-H. Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease. Diagnostics 2021, 11, 282. https://doi.org/10.3390/diagnostics11020282

AMA Style

Tsai H-J, Hung C-H, Wang C-W, Tu H-P, Li C-H, Tsai C-C, Lin W-Y, Chen S-C, Kuo C-H. Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease. Diagnostics. 2021; 11(2):282. https://doi.org/10.3390/diagnostics11020282

Chicago/Turabian Style

Tsai, Hui-Ju, Chih-Hsing Hung, Chih-Wen Wang, Hung-Pin Tu, Chiu-Hui Li, Chun-Chi Tsai, Wen-Yi Lin, Szu-Chia Chen, and Chao-Hung Kuo. 2021. "Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease" Diagnostics 11, no. 2: 282. https://doi.org/10.3390/diagnostics11020282

APA Style

Tsai, H.-J., Hung, C.-H., Wang, C.-W., Tu, H.-P., Li, C.-H., Tsai, C.-C., Lin, W.-Y., Chen, S.-C., & Kuo, C.-H. (2021). Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease. Diagnostics, 11(2), 282. https://doi.org/10.3390/diagnostics11020282

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