Effects of Environmental Heavy Metals in Soil on Estimated Glomerular Filtration Rate Variability
土壤中的重金屬對於腎絲球過濾率變異量的影響

作者:張晉鏵(Chin-Hua Chang) ； 邱炳芳(Ping-Fang Chiu) ； 吳家麟(Chia-Lin Wu) ； 許秋婷(Chew-Teng Kor) ； 連怡斌(Ie-Bin Lian) ； 張登翔(Teng-Hsiang Chang) ； 蔡俊傑(Chun-Chieh Tsai) ； 張家築(Chia-Chu Chang)

摘要

Background: Chronic kidney disease (CKD) is a common disease in Taiwan. Recently， numerous studies have shown that heavy metals can induce CKD. Accumulated evidence has shown that estimated glomerular filtration rate (eGFR) variability predicts renal prognosis and mortality rate in CKD patients. We speculated that environmental metals have an impact on variation of eGFR and further cause adverse renal outcomes. Methods: We retrospectively collected study data of patients in a CKD care program from the Division of Nephrology and Chronic Kidney Disease Education Center in Changhua Christian Hospital. We used residency data from the study data linked to data of soil metal concentrations from the nationwide systematic survey of farm soil conducted by the Environmental Protection Administration (EPA). The EPA provided the concentrations of heavy metals arsenic， mercury， cadmium， chromium， copper， nickel， lead and zinc in soil. Results: We found that four heavy metals， including Cr， Cu， Ni and Pb， were marginally significantly associated with high variation in the eGFR. According to the results of a multivariate linear regression model， there were significant associations between heavy metals and eGFR variability， especially in patients with diabetes mellitus or cerebral vascular accident. Conclusion: The results of this study demonstrated that environmental heavy metal levels have impacts on eGFR variability， especially in patients with diabetes mellitus or cerebral vascular accident. We suggest that CKD patients residing in areas with high concentrations of heavy metals in soil should attend more frequent clinical follow-ups owing to the possibility of instability in eGFR variability.

出處:The Changhua Journal of Medicine；14卷4期(2016/12/01)，P159-167