Plasma Vitamin B<sub>12</sub> and Folate Alter the Association of Blood Lead and Cadmium and Total Urinary Arsenic Levels with Chronic Kidney Disease in a Taiwanese Population

Heavy metals causing chronic nephrotoxicity may play a key role in the pathogenesis of chronic kidney disease (CKD). This study hypothesized that plasma folate and vitamin B<sub>12</sub> would modify the association of CKD with total urinary arsenic and blood lead and cadmium levels. We...

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Autores principales: Yu-Mei Hsueh, Ya-Li Huang, Yuh-Feng Lin, Horng-Sheng Shiue, Ying-Chin Lin, Hsi-Hsien Chen
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
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Acceso en línea:https://doaj.org/article/4c3e92ed054f40a7b562ddf258e1acc6
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Sumario:Heavy metals causing chronic nephrotoxicity may play a key role in the pathogenesis of chronic kidney disease (CKD). This study hypothesized that plasma folate and vitamin B<sub>12</sub> would modify the association of CKD with total urinary arsenic and blood lead and cadmium levels. We recruited 220 patients with CKD who had an estimated glomerular filtration rate of <60 mL/min/1.73 m<sup>2</sup> for ≥3 consecutive months and 438 sex- and age-matched controls. We performed inductively coupled plasma mass spectrometry to measure blood cadmium and lead levels. The urinary arsenic level was determined using a high-performance liquid chromatography–hydride generator–atomic absorption spectrometry. Plasma vitamin B<sub>12</sub> and folate levels were measured through the SimulTRAC-SNB radioassay. Compared with patients with plasma vitamin B<sub>12</sub> ≤ 6.27 pg/mL, the odds ratio (OR) and 95% confidence interval of CKD for patients with plasma vitamin B<sub>12</sub> > 9.54 pg/mL was 2.02 (1.15–3.55). However, no association was observed between plasma folate concentration and CKD. A high level of plasma vitamin B<sub>12</sub> combined with high levels of blood lead and cadmium level and total urinary arsenic tended to increase the OR of CKD in a dose-response manner, but the interactions were nonsignificant. This is the first study to demonstrate that patients with high plasma vitamin B<sub>12</sub> level exhibit increased OR of CKD related to high levels of blood cadmium and lead and total urinary arsenic.