Lead poisoning and cystatin-C in children

  • Yuri Yuri Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia.
  • Praisilia Riani Najoan Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia.
  • Stefanus Gunawan Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia.
  • Adrian Umboh Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia.
Keywords: lead poisoning, cystatin-C, AKI, children

Abstract

Background Lead pollution is a global problem both in developed and developing countries. Lead poisoning is associated with decreased glomerular filtration rate (GFR) and is a risk factor for acute kidney injury (AKI). Serum cystatin-C is a more precise test of GFR than serum creatinine level, as serum cystatin-C levels rise earlier than serum creatinine, when GFR decreases. Objective To assess for a possible correlation between lead poisoning and cystatin-C levels in children. Methods We conducted a cross-sectional study in children aged 6-11 years with a history of lead poisoning from elementary schools in Talawaan District, North Minahasa Regency from July to October 2013. Cystatin-C and blood lead levels (BLL) were measured in all subjects. Spearman’s rho test was used to analyze a potential correlation between BLL and cystatin-C level. Results This study included 41 children, comprising 21 boys and 20 girls. Their median age was 8.50 (range 6.8-10.7) years. Elevated levels of cystatin-C did not exceed normal values, however, we found a positive correlation between BLL and cystatin C (r=0.419, P=0.006). Conclusion There is a positive correlation between BLL and cystatin C level in children with lead poisoning. Regular monitoring of BLL, medical intervention, and an epidemiological study to help find the sources of contamination are needed for children with lead poisoning.

References

Meyer PA, Brown MJ, Falk H. Global approach to reducing lead exposure and poisoning. Mutat Res. 2008;659:166-75.

American Academy of Pediatrics Committee on Environmental Health. Lead exposure in children: prevention, detection, and management. Pediatrics. 2005;116:1036-46.

CDC Advisory Committee on Childhood Lead Poisoning Prevention. Interpreting and managing blood lead level <10 microg/dL in children and reducing childhood exposures to lead: recommendations of CDC’s Advisory Committee on Childhood Lead Poisoning Prevention. MMWR Recomm Rep. 2007;56:1-16.

Osman K, Elinder C, Schutz A, Grubb A. Biomarkers of nephrotoxicity in children environmental exposed to lead in Poland. J Environ Med. 1999;1:33-8.

Waikar SS, Bonventre JV. Creatinine kinetics and the definition of acute kidney injury. J Am Soc Nephrol. 2009;20:672-9.

Coll E, Botey A, Alvarez L, Poch E, Quinto L, Saurina A, et al. Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment. Am J Kidney Dis. 2000;36:29-34.

Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002;40:221-6.

Sarkar PD, Rajeshwari G, Shivaprakash TM. Cystatin C - a novel marker of glomerular filtration rate: a review. Indian J Clin Biochem. 2005;20:139-44.

Randers E, Kristensen JH, Erlandsen EJ, Danielsen H. Serum cystatin C as a marker of the renal function. Scand J Clin Lab Invest. 1998;58:585-92.

Gunawan L, Masloman N. Correlation of blood lead level and intelligence quotient in children. Paediatr Indones. 2014;54:127-31.

WHO. Inorganic lead environmental health criteria. Geneva: IPCS WHO; 1995. p. 1-14.

Ahamed M, Verma S, Kumar A, Siddiqui MK. Environmental exposure to lead and correlation with biochemical indices in children. Sci Total Environ. 2005;346:48-55. SAME AS 15

Piomelli S. Lead poisoning. In: Nathan DG, Oski FA, editors. Hematology in infancy and childhood. 4th ed. Philadelphia: WB Saunders Co; 2003. p. 473-90.

Huang F, Schneider JS. Effects of lead exposure on proliferation and differentiation of neural stem cells derived from different regions of embryonic rat brain. Neurotoxicology. 2004;25:1001-12.

Barbosa F, Fillion M, Lemire M, Passos CJ, Rodrigues JL, Philibert A, et al. Elevated blood lead levels in a riverside population in the Brazilian Amazon. Environ Res. 2009;109:594-9.

Piomelli S. Lead poisoning. In: Behrman RE, Vaughan VC, Nelson WE, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: WB Saunders Co; 2000. p. 2156-60.

Pirngadie BH. Strategi penanggulangan pencemaran udara dari sektor transportasi. Proceeding of the Simposium ke-4 FS TPT Udayana; 2001 November; Bali: Universitas Udayana; c2001.

Sumual H. Karakterisasi limbah tambang emas rakyat Dimembe Kabupaten Minahasa Utara. Agritek. 2009;17:932-7.

Center for Disease Conrol and Prevention. Notes from the field: Outbreak of acute lead poisoning among children aged <5 years—Zamfara, Nigeria, 2010. MMWR 2010;59:846.

Patrick L. Lead toxicity part II: the role of free radical damage and the use of antioxidants in the pathology and treatment of lead toxicity. Altern Med Rev. 2006;11:114-27.

Murty MS, Sharma UK, Pandey VB, Kankare SB. Serum cystatin C as a marker of renal function in detection of early acute kidney injury. Indian J Nephrol. 2013;23:180-3.

Andersen TB, Erlandsen EJ, Frokiaer J, Eskild-Jensen A, Brochner-Mortensen JB. Comparison of within- and between-subject variation of serum cystatin C and serum creatinine in children aged 2-13 years. Scand J Clin Lab Invest. 2010;70:54-9.

Spector JT, Navaas-Acien A, Fadrowski J, Guallar E, Jaar B, Weaver VM. Association of blood lead with estimated glomerular filtration rate using MDRD, CKD-EPI and serum cystatin C-based equations. Nephrol Dial Transplant. 2011;26:2786-92.

Mushak P. The nephrotoxicity of lead in human population. In: Nriagu JO, editor. Trace metals and other contaminants in the environment. Volume 10. Amsterdam: Elsevier B.V. ;2011. p. 567-95.

Bernard A. Renal and neurological effects heavy metals in the environment. In: Nriagu JO, editor. Encyclopedia of environmental health. Volume 4. Burlington: Elsevier; 2011. p. 801–5.

Staessen JA, Nawrot T, Hond ED, Thijs L, Fagard R, Hoppenbrouwers K, et al. Renal function, cytogenetic measurements, and sexual development in adolescents in relation to environmental pollutants: a feasibility study of biomarkers. Lancet. 2001;357:1660-9.

Published
2015-10-01
How to Cite
1.
Yuri Y, Najoan P, Gunawan S, Umboh A. Lead poisoning and cystatin-C in children. PI [Internet]. 1Oct.2015 [cited 23Dec.2024];55(5):252-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/45
Received 2016-02-01
Accepted 2016-02-01
Published 2015-10-01