Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis

In view of inconsistent reports on the association between chronic lead (Pb) exposure and renal injury markers (potential site of injury), the present systematic review explored their association by reviewing studies that investigated chronic Pb-exposed and those without obvious Pb exposure. Studies...

Full description

Saved in:
Bibliographic Details
Main Authors: Kuldip Upadhyay, Ankit Viramgami, Bhavani Shankara Bagepally, Rakesh Balachandar
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Toxicology Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214750024002208
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846116068555227136
author Kuldip Upadhyay
Ankit Viramgami
Bhavani Shankara Bagepally
Rakesh Balachandar
author_facet Kuldip Upadhyay
Ankit Viramgami
Bhavani Shankara Bagepally
Rakesh Balachandar
author_sort Kuldip Upadhyay
collection DOAJ
description In view of inconsistent reports on the association between chronic lead (Pb) exposure and renal injury markers (potential site of injury), the present systematic review explored their association by reviewing studies that investigated chronic Pb-exposed and those without obvious Pb exposure. Studies reporting blood Pb levels(BLL) and biomarkers of kidney injury [i.e. N-acetyl-β-D-glucosaminidase (NAG), Micro-Globulin(μG) and others] among chronic Pb-exposed and unexposed individuals were systematically searched from digital databases available until February 26, 2024. Preferred Reporting Items of Systematic Reviews and Meta-Analysis Guidelines were adhered to during the execution. Pooled effect size and heterogeneity were estimated using the random effect model and I2Studies reporting blood Pb levels(BLL) and biomarkers of kidney injury [i.e. N-acetyl-β-D-glucosaminidase (NAG), Micro-Globulin(μG) and others] among chronic Pb-exposed and unexposed individuals were systematically searched from digital databases available until February 26, 2024. Preferred Reporting Items of Systematic Reviews and Meta-Analysis Guidelines were adhered to during the execution. Pooled effect size and heterogeneity were estimated using the random effect model and I2. Pooled quantitative analysis revealed elevated BLL [25.64 (21.59–29.70) µg/dL] Pb-exposed group. The pooled analysis confirmed significantly higher urinary NAG [0.68(0.26–1.10) units], α1μG [3.82(0.96–6.68) mg/g creatinine] β2μG [1.5(0.86–2.14) units and serum creatinine [0.03(0.00–0.05) mg/dL] levels in Pb-exposed group, with high heterogeneity. Current observations indicate the proximal tubular injury as the early and potential site of Pb-induced renal injury. Pb-exposed individuals experience proximal tubular injury (KIM-1, NAG) and dysfunction (β2μG, α1μG, Cystatin-C) prior to obvious clinical renal failure. Present observations should caution the policymakers towards drafting regulations for periodic screening with markers of renal injury and / or dysfunction among those chronically exposed to lead despite the certainty of evidence is very low.
format Article
id doaj-art-f18f7562a7b745eb8082c9ba07a6d16c
institution Kabale University
issn 2214-7500
language English
publishDate 2024-12-01
publisher Elsevier
record_format Article
series Toxicology Reports
spelling doaj-art-f18f7562a7b745eb8082c9ba07a6d16c2024-12-19T10:54:59ZengElsevierToxicology Reports2214-75002024-12-0113101837Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysisKuldip Upadhyay0Ankit Viramgami1Bhavani Shankara Bagepally2Rakesh Balachandar3ICMR – National Institute of Occupational Health, Ahmedabad, IndiaICMR – National Institute of Occupational Health, Ahmedabad, IndiaICMR – National Institute of Epidemiology, Chennai, IndiaICMR – National Institute of Occupational Health, Ahmedabad, India; Correspondence to: Scientist, “E”, ICMR-National Institute of Occupational Health, Meghaninagar, Ahmedabad 380016, India.In view of inconsistent reports on the association between chronic lead (Pb) exposure and renal injury markers (potential site of injury), the present systematic review explored their association by reviewing studies that investigated chronic Pb-exposed and those without obvious Pb exposure. Studies reporting blood Pb levels(BLL) and biomarkers of kidney injury [i.e. N-acetyl-β-D-glucosaminidase (NAG), Micro-Globulin(μG) and others] among chronic Pb-exposed and unexposed individuals were systematically searched from digital databases available until February 26, 2024. Preferred Reporting Items of Systematic Reviews and Meta-Analysis Guidelines were adhered to during the execution. Pooled effect size and heterogeneity were estimated using the random effect model and I2Studies reporting blood Pb levels(BLL) and biomarkers of kidney injury [i.e. N-acetyl-β-D-glucosaminidase (NAG), Micro-Globulin(μG) and others] among chronic Pb-exposed and unexposed individuals were systematically searched from digital databases available until February 26, 2024. Preferred Reporting Items of Systematic Reviews and Meta-Analysis Guidelines were adhered to during the execution. Pooled effect size and heterogeneity were estimated using the random effect model and I2. Pooled quantitative analysis revealed elevated BLL [25.64 (21.59–29.70) µg/dL] Pb-exposed group. The pooled analysis confirmed significantly higher urinary NAG [0.68(0.26–1.10) units], α1μG [3.82(0.96–6.68) mg/g creatinine] β2μG [1.5(0.86–2.14) units and serum creatinine [0.03(0.00–0.05) mg/dL] levels in Pb-exposed group, with high heterogeneity. Current observations indicate the proximal tubular injury as the early and potential site of Pb-induced renal injury. Pb-exposed individuals experience proximal tubular injury (KIM-1, NAG) and dysfunction (β2μG, α1μG, Cystatin-C) prior to obvious clinical renal failure. Present observations should caution the policymakers towards drafting regulations for periodic screening with markers of renal injury and / or dysfunction among those chronically exposed to lead despite the certainty of evidence is very low.http://www.sciencedirect.com/science/article/pii/S2214750024002208Kidney injury markersLead exposureN-acetyl-β-D-glucosaminidaseβ-2-microglobulineKidney Injury Molecule-1Systematic review
spellingShingle Kuldip Upadhyay
Ankit Viramgami
Bhavani Shankara Bagepally
Rakesh Balachandar
Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis
Toxicology Reports
Kidney injury markers
Lead exposure
N-acetyl-β-D-glucosaminidase
β-2-microglobuline
Kidney Injury Molecule-1
Systematic review
title Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis
title_full Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis
title_fullStr Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis
title_full_unstemmed Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis
title_short Association between chronic lead exposure and markers of kidney injury: A systematic review and meta-analysis
title_sort association between chronic lead exposure and markers of kidney injury a systematic review and meta analysis
topic Kidney injury markers
Lead exposure
N-acetyl-β-D-glucosaminidase
β-2-microglobuline
Kidney Injury Molecule-1
Systematic review
url http://www.sciencedirect.com/science/article/pii/S2214750024002208
work_keys_str_mv AT kuldipupadhyay associationbetweenchronicleadexposureandmarkersofkidneyinjuryasystematicreviewandmetaanalysis
AT ankitviramgami associationbetweenchronicleadexposureandmarkersofkidneyinjuryasystematicreviewandmetaanalysis
AT bhavanishankarabagepally associationbetweenchronicleadexposureandmarkersofkidneyinjuryasystematicreviewandmetaanalysis
AT rakeshbalachandar associationbetweenchronicleadexposureandmarkersofkidneyinjuryasystematicreviewandmetaanalysis