Urinary lead concentration in chronic kidney disease patient in a tertiary care hospital in Sabah, Malaysia
Urine is frequently used as a biomarker to quantify lead (Pb) toxicity levels, especially in those affected with kidney disease. Presently, scientific knowledge on the association between urinary lead (UPb) concentration and renal profile is limited, which contradicts the evaluations of health-based...
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| Format: | Thesis |
| Language: | English English |
| Published: |
2020
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| Subjects: | |
| Online Access: | https://eprints.ums.edu.my/id/eprint/42042/1/24%20PAGES.pdf https://eprints.ums.edu.my/id/eprint/42042/2/FULLTEXT.pdf |
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| Summary: | Urine is frequently used as a biomarker to quantify lead (Pb) toxicity levels, especially in those affected with kidney disease. Presently, scientific knowledge on the association between urinary lead (UPb) concentration and renal profile is limited, which contradicts the evaluations of health-based Pb nephropathy. In the case of patients with chronic kidney disease (CKD) associated with long term Pb toxicity due to the accumulation of Pb in the kidneys, there is currently no complete explanation for high concentrations of UPb that could aggravate existing kidney disease. Furthermore, most studies have failed to adequately report the effects of UPb concentration and this has become an isolated screening practice in detecting the early signs of Pb nephropathy in patients. The objective of this cross-sectional study was to examine the concentrations of UPb and renal outcomes in CKD patients who were referred to the Nephrology Clinic at Queen Elizabeth Hospital, Sabah. Two hospitals were selected as the study population, namely Queen Elizabeth Hospital and Papar Hospital. Purposive Sample Method technique was used in the selection of samples with a minimum of 100 subjects required in total. Primary data on serum creatinine (SCr), blood urea nitrogen (BUN), diastolic blood pressure (BP), and demographic background was obtained during clinic visits as well as urine samples. The UPb concentration results and the primary data were analyzed using SPSS version 21 software to demonstrate the descriptive analysis of UPb concentration in the study group. The mean UPb concentration was 4.1±7.92μg/g for the CKD group and 3.8±2.93μg/g for the non-CKD group. A significant difference was observed in UPb concentration levels between the study groups, whereby the CKD group had higher UPb concentration levels than the non- CKD group (p-=0.002). However, there was no evidence of a relationship between UPb concentration and SCr concentration, BUN concentration, and diastolic BP in the CKD group in which the correlation was r=-0.123, r=0.101, r=0.127, respectively. Furthermore, no evidence was found of UPb accumulation in the CKD patients who had yet to start renal replacement therapy (RRT). As such, no reverse causation of Pb was evident in the CKD group. The possibility of Pb accumulation may potentially increase in a patient who has already started RRT or is no longer producing urine. Further larger scale studies are needed to demonstrate whether UPb concentration affects kidney function in society as a whole. |
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