The association of urine arsenic with prevalent and incident chronic kidney disease: evidence from the Strong Heart Study.

MedStar author(s):
Citation: Epidemiology. 26(4):601-12, 2015 Jul.PMID: 25929811Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., Extramural | Research Support, U.S. Gov't, P.H.S.Subject headings: *Arsenic/ur [Urine] | *Environmental Exposure/sn [Statistics & Numerical Data] | *Indians, North American/sn [Statistics & Numerical Data] | *Renal Insufficiency, Chronic/ep [Epidemiology] | Aged | Arizona/ep [Epidemiology] | Arsenicals/ur [Urine] | Cacodylic Acid/ur [Urine] | Cohort Studies | Cross-Sectional Studies | Female | Glomerular Filtration Rate | Humans | Incidence | Male | Middle Aged | North Dakota/ep [Epidemiology] | Oklahoma/ep [Epidemiology] | Prevalence | Proportional Hazards Models | Prospective Studies | South Dakota/ep [Epidemiology] | United States/ep [Epidemiology]Year: 2015Local holdings: Available online from MWHC library: 2000 - presentISSN:
  • 1044-3983
Name of journal: Epidemiology (Cambridge, Mass.)Abstract: BACKGROUND: Few studies have evaluated associations between low to moderate arsenic levels and chronic kidney disease (CKD). The objective was to evaluate the associations of inorganic arsenic exposure with prevalent and incident CKD in American Indian adults.CONCLUSIONS: The inverse association of urine inorganic arsenic with prevalent CKD suggests that kidney disease affects excretion of inorganic arsenic. Arsenic species were positively associated with incident CKD. Studies with repeated measures are needed to further characterize the relation between arsenic and kidney disease development.METHODS: We evaluated the associations of inorganic arsenic exposure with CKD in American Indians who participated in the Strong Heart Study in 3,851 adults ages 45-74 years in a cross-sectional analysis, and 3,119 adults with follow-up data in a prospective analysis. Inorganic arsenic, monomethylarsonate, and dimethylarsinate were measured in urine at baseline. CKD was defined as estimated glomerular filtration rate < 60ml/min/1.73 m, kidney transplant or dialysis.RESULTS: CKD prevalence was 10.3%. The median (IQR) concentration of inorganic plus methylated arsenic species (total arsenic) in urine was 9.7 (5.8, 15.7) mug/L. The adjusted odds ratio (OR; 95% confidence interval) of prevalent CKD for an interquartile range in total arsenic was 0.7 (0.6, 0.8), mostly due to an inverse association with inorganic arsenic (OR: 0.4 [0.3, 0.4]). Monomethylarsonate and dimethylarsinate were positively associated with prevalent CKD after adjustment for inorganic arsenic (OR: 3.8 and 1.8). The adjusted hazard ratio of incident CKD for an IQR in sum of inorganic and methylated arsenic was 1.2 (1.03, 1.41). The corresponding HRs for inorganic arsenic, monomethylarsonate, and dimethylarsinate were 1.0 (0.9, 1.2), 1.2 (1.00, 1.3), and 1.2 (1.0, 1.4).All authors: Bandeen-Roche K, Francesconi KA, Goessler W, Guallar E, Howard BV, Navas-Acien A, Silbergeld EK, Umans JG, Weaver VM, Yeh F, Zheng LYFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-05-24
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 25929811 Available 25929811

Available online from MWHC library: 2000 - present

BACKGROUND: Few studies have evaluated associations between low to moderate arsenic levels and chronic kidney disease (CKD). The objective was to evaluate the associations of inorganic arsenic exposure with prevalent and incident CKD in American Indian adults.

CONCLUSIONS: The inverse association of urine inorganic arsenic with prevalent CKD suggests that kidney disease affects excretion of inorganic arsenic. Arsenic species were positively associated with incident CKD. Studies with repeated measures are needed to further characterize the relation between arsenic and kidney disease development.

METHODS: We evaluated the associations of inorganic arsenic exposure with CKD in American Indians who participated in the Strong Heart Study in 3,851 adults ages 45-74 years in a cross-sectional analysis, and 3,119 adults with follow-up data in a prospective analysis. Inorganic arsenic, monomethylarsonate, and dimethylarsinate were measured in urine at baseline. CKD was defined as estimated glomerular filtration rate < 60ml/min/1.73 m, kidney transplant or dialysis.

RESULTS: CKD prevalence was 10.3%. The median (IQR) concentration of inorganic plus methylated arsenic species (total arsenic) in urine was 9.7 (5.8, 15.7) mug/L. The adjusted odds ratio (OR; 95% confidence interval) of prevalent CKD for an interquartile range in total arsenic was 0.7 (0.6, 0.8), mostly due to an inverse association with inorganic arsenic (OR: 0.4 [0.3, 0.4]). Monomethylarsonate and dimethylarsinate were positively associated with prevalent CKD after adjustment for inorganic arsenic (OR: 3.8 and 1.8). The adjusted hazard ratio of incident CKD for an IQR in sum of inorganic and methylated arsenic was 1.2 (1.03, 1.41). The corresponding HRs for inorganic arsenic, monomethylarsonate, and dimethylarsinate were 1.0 (0.9, 1.2), 1.2 (1.00, 1.3), and 1.2 (1.0, 1.4).

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