High prevalence of elevated lead levels in pediatric dialysis patients

Background After parents raised concerns about potential lead (Pb) contamination of calcium carbonate for treatment of hyperphosphatemia in chronic kidney disease (CKD), we measured blood Pb using high-resolution sector field inductively coupled mass spectrometry in a quality-assurance investigation...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2012-09, Vol.27 (9), p.1551-1556
Main Authors: Filler, Guido, Roach, Elizabeth, Yasin, Abeer, Sharma, Ajay P., Blake, Peter G., Yang, Liju
Format: Article
Language:English
Subjects:
Adolescent
Adults
Anemia
Antacids - adverse effects
Blood
Calcium carbonate
Calcium Carbonate - adverse effects
Care and treatment
Child
Child, Preschool
Chronic kidney failure
Cognition & reasoning
Costs (Law)
Cross-Sectional Studies
Dentistry
Drug dosages
Female
Glomerular Filtration Rate - physiology
Hemodialysis
Humans
Hyperphosphatemia - drug therapy
Infant
Iron
Kidney diseases
Lead - blood
Lead content
Male
Mass Spectrometry
Medicine
Medicine & Public Health
Nephrology
Original Article
Pediatrics
Peritoneal dialysis
Prevalence
Prevalence studies (Epidemiology)
Renal Dialysis
Renal Insufficiency, Chronic - physiopathology
Renal Insufficiency, Chronic - therapy
Scientific imaging
Urology
Young Adult
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Summary:Background After parents raised concerns about potential lead (Pb) contamination of calcium carbonate for treatment of hyperphosphatemia in chronic kidney disease (CKD), we measured blood Pb using high-resolution sector field inductively coupled mass spectrometry in a quality-assurance investigation of ten pediatric dialysis patients (nine on hemodialysis) and six patients before dialysis. Methods We assessed the kidney function as cystatin C estimated glomerular filtration rate (eGFR), blood Pb levels, calcium carbonate dose, and standard laboratory parameters, as well as Pb levels in the dialysis feed water. Results Mean blood Pb concentration in the 16 pediatric CKD patients was 21.1 ± 15.8 µg/l with a maximum of 58 µg/l, which was significantly higher than that of 467 apparently healthy controls (median 6.35 µg/l, interquartile range 4.47, 8.71) and comparable to that of ten adult peritoneal dialysis (PD) patients. Lead levels correlated with red blood cell distribution width, eGFR, and calcium carbonate dose. Pb in dialysate feed water was always
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-012-2150-8