Module 3: Toxicology - Section 14: Renal-urinary tract and the kidney

TOX 14.3: Notes on a South African study of lead and nephrotoxicity

Notes on a South African study of lead and nephrotoxicity:

This study was done in a workforce in a battery factory in East London at the instigation of the trade union.

We did not find:

1. An excess of hypertension. (In fact we found much less hypertension in this mainly Ciskeian based male adult population than one would expect from the generally accepted epidemiology of this disorder in South Africa. This may have been a healthy worker effect).
2. Anaemia
3. Protein in the urine
4. That specialised markers of kidney damage added much.

We did find:

1. A dose response association of lead and ZPP with markers of renal dysfunction, particularly serum creatinine.
2. A surprisingly high number of cases of early renal failure, in the form of persistently elevated creatinine (and in a couple of cases advanced renal failure).
3. Uric acid was a useful outcome of clinical effect. (Gout was found in a few workers).
4. Significantly different blood lead readings between two different laboratories on split specimens.

REFERENCE:

Ehrlich et al. Lead absorption and renal dysfunction in a South African battery factory. Occup Environ Med 1998;55:453-460.

Postgraduate Diploma in Occupational Health (DOH) - Modules 3: Occupational Medicine & Toxicology (Basic) by Profs Mohamed Jeebhay and Rodney Ehrlich, Health Sciences UCT is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 2.5 South Africa License. Major contributors: Mohamed Jeebhay, Rodney Ehrlich, Jonny Myers, Leslie London, Sophie Kisting, Gail Todd, Neil White. Source available from here. For any updates to the material, or more permissions beyond the scope of this license, please email healthoer@uct.ac.za or visit www.healthedu.uct.ac.za. Last updated Jan 2007.
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