TY - JOUR
T1 - Urine arsenic and prevalent albuminuria
T2 - Evidence from a population-based study
AU - Zheng, Laura Y.
AU - Umans, Jason G.
AU - Tellez-Plaza, Maria
AU - Yeh, Fawn
AU - Francesconi, Kevin A.
AU - Goessler, Walter
AU - Silbergeld, Ellen K.
AU - Guallar, Eliseo
AU - Howard, Barbara V.
AU - Weaver, Virginia M.
AU - Navas-Acien, Ana
PY - 2013/3
Y1 - 2013/3
N2 - Background: Long-term arsenic exposure is a major global health problem. However, few epidemiologic studies have evaluated the association of arsenic with kidney measures. Our objective was to evaluate the cross-sectional association between inorganic arsenic exposure and albuminuria in American Indian adults from rural areas of Arizona, Oklahoma, and North and South Dakota. Study Design: Cross-sectional. Setting & Partipants: Strong Heart Study locations in Arizona, Oklahoma, and North and South Dakota. 3,821 American Indian men and women aged 45-74 years with urine arsenic and albumin measurements. Predictor: Urine arsenic. Outcomes: Urine albumin-creatinine ratio and albuminuria status. Measurements: Arsenic exposure was estimated by measuring total urine arsenic and urine arsenic species using inductively coupled plasma mass spectrometry (ICPMS) and high-performance liquid chromatography-ICPMS, respectively. Urine albumin was measured by automated nephelometric immunochemistry. Results: The prevalence of albuminuria (albumin-creatinine ratio ≥30 mg/g) was 30%. Median value for the sum of inorganic and methylated arsenic species was 9.7 (IQR, 5.8-15.6) μg per gram of creatinine. Multivariable-adjusted prevalence ratios of albuminuria (albumin-creatinine ratio ≥30 mg/g) comparing the 3 highest to lowest quartiles of the sum of inorganic and methylated arsenic species were 1.16 (95% CI, 1.00-1.34), 1.24 (95% CI, 1.07-1.43), and 1.55 (95% CI, 1.35-1.78), respectively (P for trend <0.001). The association between urine arsenic and albuminuria was observed across all participant subgroups evaluated and was evident for both micro- and macroalbuminuria. Limitations: The cross-sectional design cannot rule out reverse causation. Conclusions: Increasing urine arsenic concentrations were cross-sectionally associated with increased albuminuria in a rural US population with a high burden of diabetes and obesity. Prospective epidemiologic and mechanistic evidence is needed to understand the role of arsenic as a kidney disease risk factor.
AB - Background: Long-term arsenic exposure is a major global health problem. However, few epidemiologic studies have evaluated the association of arsenic with kidney measures. Our objective was to evaluate the cross-sectional association between inorganic arsenic exposure and albuminuria in American Indian adults from rural areas of Arizona, Oklahoma, and North and South Dakota. Study Design: Cross-sectional. Setting & Partipants: Strong Heart Study locations in Arizona, Oklahoma, and North and South Dakota. 3,821 American Indian men and women aged 45-74 years with urine arsenic and albumin measurements. Predictor: Urine arsenic. Outcomes: Urine albumin-creatinine ratio and albuminuria status. Measurements: Arsenic exposure was estimated by measuring total urine arsenic and urine arsenic species using inductively coupled plasma mass spectrometry (ICPMS) and high-performance liquid chromatography-ICPMS, respectively. Urine albumin was measured by automated nephelometric immunochemistry. Results: The prevalence of albuminuria (albumin-creatinine ratio ≥30 mg/g) was 30%. Median value for the sum of inorganic and methylated arsenic species was 9.7 (IQR, 5.8-15.6) μg per gram of creatinine. Multivariable-adjusted prevalence ratios of albuminuria (albumin-creatinine ratio ≥30 mg/g) comparing the 3 highest to lowest quartiles of the sum of inorganic and methylated arsenic species were 1.16 (95% CI, 1.00-1.34), 1.24 (95% CI, 1.07-1.43), and 1.55 (95% CI, 1.35-1.78), respectively (P for trend <0.001). The association between urine arsenic and albuminuria was observed across all participant subgroups evaluated and was evident for both micro- and macroalbuminuria. Limitations: The cross-sectional design cannot rule out reverse causation. Conclusions: Increasing urine arsenic concentrations were cross-sectionally associated with increased albuminuria in a rural US population with a high burden of diabetes and obesity. Prospective epidemiologic and mechanistic evidence is needed to understand the role of arsenic as a kidney disease risk factor.
KW - Albuminuria
KW - American Indian
KW - arsenic
KW - kidney disease
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UR - http://www.scopus.com/inward/citedby.url?scp=84874082135&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2012.09.011
DO - 10.1053/j.ajkd.2012.09.011
M3 - Article
C2 - 23142528
AN - SCOPUS:84874082135
SN - 0272-6386
VL - 61
SP - 385
EP - 394
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 3
ER -