Urine arsenic and prevalent albuminuria: evidence from a population-based study.

MedStar author(s):
Citation: American Journal of Kidney Diseases. 61(3):385-94, 2013 Mar.PMID: 23142528Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., ExtramuralSubject headings: *Albuminuria/ur [Urine] | *Arsenic/ur [Urine] | Aged | Albuminuria/ep [Epidemiology] | Cross-Sectional Studies | Female | Humans | Male | Middle AgedYear: 2013Local holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0272-6386
Name of journal: American journal of kidney diseases : the official journal of the National Kidney FoundationAbstract: BACKGROUND: Long-term arsenic exposure is a major global health problem. However, few epidemiologic studies have evaluated the association of arsenic with kidney measures. Our objective was to evaluate the cross-sectional association between inorganic arsenic exposure and albuminuria in American Indian adults from rural areas of Arizona, Oklahoma, and North and South Dakota.CONCLUSIONS: Increasing urine arsenic concentrations were cross-sectionally associated with increased albuminuria in a rural US population with a high burden of diabetes and obesity. Prospective epidemiologic and mechanistic evidence is needed to understand the role of arsenic as a kidney disease risk factor. Copyright 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.LIMITATIONS: The cross-sectional design cannot rule out reverse causation.MEASUREMENTS: Arsenic exposure was estimated by measuring total urine arsenic and urine arsenic species using inductively coupled plasma mass spectrometry (ICPMS) and high-performance liquid chromatography-ICPMS, respectively. Urine albumin was measured by automated nephelometric immunochemistry.OUTCOMES: Urine albumin-creatinine ratio and albuminuria status.PREDICTOR: Urine arsenic.RESULTS: The prevalence of albuminuria (albumin-creatinine ratio >=30 mg/g) was 30%. Median value for the sum of inorganic and methylated arsenic species was 9.7 (IQR, 5.8-15.6) ug per gram of creatinine. Multivariable-adjusted prevalence ratios of albuminuria (albumin-creatinine ratio >=30 mg/g) comparing the 3 highest to lowest quartiles of the sum of inorganic and methylated arsenic species were 1.16 (95% CI, 1.00-1.34), 1.24 (95% CI, 1.07-1.43), and 1.55 (95% CI, 1.35-1.78), respectively (P for trend <0.001). The association between urine arsenic and albuminuria was observed across all participant subgroups evaluated and was evident for both micro- and macroalbuminuria.STUDY DESIGN: Cross-sectional. SETTING & PARTIPANTS: Strong Heart Study locations in Arizona, Oklahoma, and North and South Dakota. 3,821 American Indian men and women aged 45-74 years with urine arsenic and albumin measurements.All authors: Francesconi KA, Goessler W, Guallar E, Howard BV, Navas-Acien A, Silbergeld EK, Tellez-Plaza M, Umans JG, Weaver VM, Yeh F, Zheng LYFiscal year: Digital Object Identifier: Date added to catalog: 2013-09-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 23142528

Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Long-term arsenic exposure is a major global health problem. However, few epidemiologic studies have evaluated the association of arsenic with kidney measures. Our objective was to evaluate the cross-sectional association between inorganic arsenic exposure and albuminuria in American Indian adults from rural areas of Arizona, Oklahoma, and North and South Dakota.

CONCLUSIONS: Increasing urine arsenic concentrations were cross-sectionally associated with increased albuminuria in a rural US population with a high burden of diabetes and obesity. Prospective epidemiologic and mechanistic evidence is needed to understand the role of arsenic as a kidney disease risk factor. Copyright 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

LIMITATIONS: The cross-sectional design cannot rule out reverse causation.

MEASUREMENTS: Arsenic exposure was estimated by measuring total urine arsenic and urine arsenic species using inductively coupled plasma mass spectrometry (ICPMS) and high-performance liquid chromatography-ICPMS, respectively. Urine albumin was measured by automated nephelometric immunochemistry.

OUTCOMES: Urine albumin-creatinine ratio and albuminuria status.

PREDICTOR: Urine arsenic.

RESULTS: The prevalence of albuminuria (albumin-creatinine ratio >=30 mg/g) was 30%. Median value for the sum of inorganic and methylated arsenic species was 9.7 (IQR, 5.8-15.6) ug per gram of creatinine. Multivariable-adjusted prevalence ratios of albuminuria (albumin-creatinine ratio >=30 mg/g) comparing the 3 highest to lowest quartiles of the sum of inorganic and methylated arsenic species were 1.16 (95% CI, 1.00-1.34), 1.24 (95% CI, 1.07-1.43), and 1.55 (95% CI, 1.35-1.78), respectively (P for trend <0.001). The association between urine arsenic and albuminuria was observed across all participant subgroups evaluated and was evident for both micro- and macroalbuminuria.

STUDY DESIGN: Cross-sectional. SETTING & PARTIPANTS: Strong Heart Study locations in Arizona, Oklahoma, and North and South Dakota. 3,821 American Indian men and women aged 45-74 years with urine arsenic and albumin measurements.

English

Powered by Koha