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

by Howard, Barbara V; Umans, Jason G.
Citation: American Journal of Kidney Diseases. 61(3):385-94, 2013 Mar..Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation.Published: 2013ISSN: 0272-6386.Full author list: Francesconi KA; Goessler W; Guallar E; Howard BV; Navas-Acien A; Silbergeld EK; Tellez-Plaza M; Umans JG; Weaver VM; Yeh F; Zheng LY.UI/PMID: 23142528.Subject(s): *Albuminuria/ur [Urine] | *Arsenic/ur [Urine] | Aged | Albuminuria/ep [Epidemiology] | Cross-Sectional Studies | Female | Humans | Male | Middle AgedInstitution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal Article | Research Support, N.I.H., ExtramuralOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: Am J Kidney Dis. 61(3):385-94, 2013 Mar.Local Holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006.Abstract: 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.Abstract: 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.Abstract: LIMITATIONS: The cross-sectional design cannot rule out reverse causation.Abstract: 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.Abstract: OUTCOMES: Urine albumin-creatinine ratio and albuminuria status.Abstract: PREDICTOR: Urine arsenic.Abstract: 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.Abstract: 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.

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