Huizen, S. van (Sanne) (2015) The association between cadmium, lead and proteinuria in a population diagnosed with type 2 Diabetes Mellitus. thesis, Medicine.
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Abstract
Background: Diabetic nephropathy is a common complication of diabetes mellitus, which may lead to end-stage renal disease and haemodialysis. In 20-40 percent of the people who start haemodialysis treatment for end-stage renal disease, diabetic nephropathy is the primary underlying diagnosis. Clinically, diabetic nephropathy is characterized by an increased urinary albumin-creatinine ratio and a decreased glomerular filtration rate (GFR). Heavy metals, such as cadmium and lead are nephrotoxic in a healthy population. There are still many unknowns about the association of heavy metals and renal injury in populations with diabetes mellitus type 2 (DM2). Objective: This study will focus on the possible association between heavy metals, as cadmium and lead, and the progression of proteinuria in patients with DM2 in a Dutch population. Martial and Methods: In this cross-sectional cohort study 218 patients with DM2 were included. Proteinuria was defined as an albumin-creatinine ratio > 2.5g/mol in men and > 3.5g/mol in women. The cadmium and lead concentration were determined in EDTA whole blood. In addition, some demographic data, macro- and microvascular complications, serum- and urinary concentrations were analysed. Results: In 36 percent of the patients there was proteinuria. None of the patients had a cadmium – or lead blood concentration above the acceptable limit of 5.0 μg/L and 100 μg/dL, respectively. In a multivariate analysis, no association was found between cadmium and proteinuria. There was a significant correlation between lead concentration and the presence of proteinuria (OR 1,667, p=0,010). Conclusion: Our study results suggest that lead, even at a low level, is associated with proteinuria in a DM2 population. No association between cadmium and proteinuria was found. Further research is needed to identify the pathophysiological mechanism and long-term comorbidity of lead and cadmium in a DM2 population.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Laverman, dr. G.D. and Locatie: ZGT Almelo; afdeling interne geneeskunde and nefrologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1327 |
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