Blood Lead in End-Stage Renal
Disease (ESRD) Patients who were on Maintainence Haemodialysis
Dr. Subha Palaneeswari M,
Assistant Professor, Department of Biochemistry,
Sree Balaji Medical College and Hospital,
Chrompet, Chennai-600 044,India.
Background: In India, there is rising burden of chronic diseases like hypertension and diabetes. It has been estimated that 25-40% of these patients are likely to develop CKD, with a significant percentage requiring renal replacement therapy. Haemodialysis is the most common method which is used to treat advanced and permanent kidney failure. The derangements in the metabolism of several toxic and trace elements such as antimony, arsenic, cadmium, molybdenum, nickel, and selenium have been reported for several decades in patients with chronically reduced renal function. Overall, the available literature suggests that the blood levels of some elements such as cadmium, chromium, fluorine, iodine, lead and vanadium are high in ESRD.
Aim and Objectives: Our aim was to study the levels of blood lead in the End-Stage Renal Disease (ESRD) patients who were on Maintenance Haemodialysis (MHD), and to study whether there was any relationship between the blood lead concentration and the duration of MHD.
Methods: The blood lead level was determined in 50 healthy subjects with normal renal function and in 50 patients with ESRD who were on MHD. None of them had a history of smoking or any industrial exposure.
Results: The results of this study revealed that the blood lead level was higher in the ESRD patients who were on MHD than in the healthy adults. The blood lead concentration was found to increase with the duration of the MHD.
Conclusion: The mild increase in the blood lead level with an increase in the duration of MHD in the study population, may be viewed in the wider context that the prolonged exposure to lead, even at low levels may result in CKD by causing interstitial nephritis, hypertension, hyperuricaemia, an increased incidence of hypertension, cerebrovascular disease and cardiovascular disease or the progression of an already existing CKD.