PMID: 7544066Jun 1, 1995Paper

Lead-induced nephropathy: relationship between various biological exposure indices and early markers of nephrotoxicity

American Journal of Industrial Medicine
K S ChiaE Lee

Abstract

Lead nephropathy in adults is silent and insidious, characterized by the absence of proteinuria in its early phase. Of the early markers of nephrotoxicity, urinary N-acetyl-beta-D-glucosaminidase (NAG) appears to be the only one that is elevated in early lead nephropathy. However, the elevation in urinary NAG activity may be a response to a sharp increase in renal burden of lead. Its usefulness as a marker of chronic lead nephropathy is thus in doubt. There is a need, then, to identify a reliable early biological indicator of lead-induced kidney damage. Furthermore, there is also a need to identify suitable markers of chronic exposure to describe meaningful dose-response and dose-effect relationships. Traditionally, blood lead (PbB) was used, but the current blood lead level (PbBrec) is more an indicator of recent exposure. Time-integrated blood lead indices (PbBint) derived from repeated serial PbB measurements can be used as indices of chronic exposure. In 128 lead-exposed workers, the PbBint was the most important exposure variable in describing the variability in urinary alpha 1-microglobulin (U alpha 1 m), urinary beta 2-microglobulin (U beta 2m), and urinary retinol binding protein (URBP). U alpha 1m was the only marker t...Continue Reading

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Citations

Mar 24, 2004·Archives of Medical Research·Ibrahim A M EL-SaftyAhmed K R EL-Sady
May 15, 2003·Journal of Toxicology and Environmental Health. Part a·Claire de BurbureAntonio Mutti
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Jun 11, 2004·Disease-a-month : DM·Anne Krantz, Samuel Dorevitch

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