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Title: Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents

Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m{sup 2}; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. - Highlights: •more » Positive associations between urine metals and creatinine-based eGFR are unexpected. • Optimal approach to urine concentration adjustment for urine biomarkers uncertain. • We compared urine concentration adjustment methods. • Positive associations observed only with urine creatinine adjustment. • Additional research using non-creatinine-based methods of adjustment needed.« less
Authors:
 [1] ;  [2] ;  [2] ;  [3] ;  [4] ;  [1] ;  [5] ;  [6] ;  [2] ;  [3] ;  [7] ;  [2] ;  [7] ;
  1. Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States)
  2. (United States)
  3. Faculty of Medicine, University of Juárez of Durango State, Durango (Mexico)
  4. (Mexico)
  5. Instituto Nacional de Salud Publica, Centro de Investigacion en Salud Poblacional, Cuernavaca, Morelos (Mexico)
  6. Johns Hopkins University School of Medicine, Baltimore, MD (United States)
  7. Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY (United States)
Publication Date:
OSTI Identifier:
22447524
Resource Type:
Journal Article
Resource Relation:
Journal Name: Environmental Research; Journal Volume: 132; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
54 ENVIRONMENTAL SCIENCES; ABUNDANCE; ADOLESCENTS; BIOLOGICAL MARKERS; CADMIUM; CONCENTRATION RATIO; CREATININE; ECOLOGICAL CONCENTRATION; FILTRATION; HEART; ICP MASS SPECTROSCOPY; LEAD; MASS SPECTROMETERS; NITRIC ACID; PETROLEUM RESIDUES; THALLIUM; URANIUM; URINE