| Title | Associations between exposure to heavy metals and the risk of chronic kidney disease: a systematic review and meta-analysis |
| Authors | Jalili, Cyrus Kazemi, Maryam Cheng, Hefa Mohammadi, Hamed Babaei, Atefeh Taheri, Ensiyeh Moradi, Sajjad |
| Affiliation | Kermanshah Univ Med Sci, Hlth Technol Inst, Med Biol Res Ctr, Kermanshah, Iran Cornell Univ, Human Metab Res Unit, Div Nutr Sci, New York, NY 10021 USA Peking Univ, Coll Urban & Environm Sci, MOE Key Lab Earth Surface Proc, Beijing, Peoples R China Isfahan Univ Med Sci, Sch Nutr & Food Sci, Dept Clin Nutr, Esfahan, Iran Isfahan Univ Med Sci, Res Inst Primordial Prevent Noncommunicable Dis, Environm Res Ctr, Esfahan, Iran Isfahan Univ Med Sci, Sch Hlth, Dept Environm Hlth Engn, Esfahan, Iran Halal Res Ctr IRI, FDA, Tehran, Iran |
| Keywords | LOW-LEVEL EXPOSURE GLOMERULAR-FILTRATION-RATE RENAL TUBULAR DYSFUNCTION CADMIUM EXPOSURE BLOOD CADMIUM GENERAL-POPULATION URINARY CADMIUM ENVIRONMENTAL EXPOSURE RACIAL-DIFFERENCES LEAD-EXPOSURE |
| Issue Date | Feb-2021 |
| Publisher | CRITICAL REVIEWS IN TOXICOLOGY |
| Abstract | We performed a systematic review and meta-analysis to examine the relationship between heavy metals (HMs) exposure and the risk of chronic kidney disease (CKD). Databases of Web of Science, Embase, MEDLINE, and Scopus were searched through June 2020 to identify studies assessing the relationships between exposure to HMs (i.e. cadmium, lead, arsenic, mercury) and the risk of CKD, evaluated by decreased estimated glomerular filtration rate (eGFR) and/or increased proteinuria risks in adults (>= 18 years). Data were pooled by random-effects models and expressed as weighted mean differences and 95% confidence intervals. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS). Twenty-eight eligible articles (n = 107,539 participants) were included. Unlike eGFR risk (p = 0.10), Cadmium exposure was associated with an increased proteinuria risk (OR = 1.35; 95% CI: 1.13, 1.61; p < 0.001; I-2 = 79.7%). Lead exposure was associated with decreased eGFR (OR = 1.12; 95%CI: 1.03, 1.22; p = 0.008; I-2 = 87.8%) and increased proteinuria (OR = 1.25; 95% CI: 1.04, 1.49; p = 0.02; I-2 = 79.6) risks. Further, arsenic exposure was linked to a decreased eGFR risk (OR = 1.55; 95% CI: 1.05, 2.28; p = 0.03; I-2 = 89.1%) in contrast to mercury exposure (p = 0.89). Only two studies reported the link between arsenic exposure and proteinuria risk, while no study reported the link between mercury exposure and proteinuria risk. Exposure to cadmium, lead, and arsenic may increase CKD risk in adults, albeit studies were heterogeneous, warranting further investigations. Our observations support the consideration of these associations for preventative, diagnostic, monitoring, and management practices of CKD. |
| URI | http://hdl.handle.net/20.500.11897/612626 |
| ISSN | 1040-8444 |
| DOI | 10.1080/10408444.2021.1891196 |
| Indexed | SCI(E) |
| Appears in Collections: | 城市与环境学院 地表过程分析与模拟教育部重点实验室 |
