Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran.
Rev Environ Health. 2020 Nov 2;36(3):359-366. doi: 10.1515/reveh-2020-0110. Print 2021 Sep 27.
Heavy metals in drinking water can threat human health and may induce several diseases. The association between heavy metals exposure and chronic kidney disease (CKD) has been indicated by few epidemiological studies. We conducted a systematic review of the epidemiologic publications of the association between exposure to heavy metals through drinking water and CKD. Keywords related to heavy metals and kidney diseases on MeSH were identified and searched in PubMed, Google Scholar, Scopus, Ovid-Medline and Web of Science until July 2020. 14 publications met our inclusion criteria and included in the current review. The included articles were conducted on the association between arsenic, cadmium, lead and chromium in drinking water and CKD. Our study could not find strong evidence between heavy exposure to through drinking water and CKD, except for arsenic. The negative association was found between arsenic and lead and glomerular filtration rate (eGFR). The positive correlation was observed between cadmium exposure and urinary N-acetyl--d-glucosaminidase (NAG) concentrations, and also arsenic and chromium exposure and kidney injury molecule (KIM-1). Assessment of studies showed an association between arsenic, cadmium, lead and chromium and albuminuria and proteinuria, without CKD outcomes. Current systematic study showed few evidence for exposure to arsenic, cadmium, lead and chromium through drinking water and incidence of kidney problems. However, more epidemiological studies are required to confirm this association.
饮用水中的重金属会威胁人类健康，并可能引发多种疾病。一些流行病学研究表明，重金属暴露与慢性肾脏病（CKD）之间存在关联。我们对通过饮用水暴露于重金属与 CKD 之间关联的流行病学研究进行了系统评价。在 PubMed、Google Scholar、Scopus、Ovid-Medline 和 Web of Science 中，使用 MeSH 上与重金属和肾脏疾病相关的关键字进行了搜索，检索时间截至 2020 年 7 月。有 14 篇符合纳入标准的文献纳入本综述。纳入的文章研究了饮用水中砷、镉、铅和铬与 CKD 之间的关系。除了砷之外，我们的研究未能发现重金属通过饮用水暴露与 CKD 之间存在强相关性。在肾小球滤过率（eGFR）方面，发现砷和铅与高暴露之间存在负相关，而镉暴露与尿 N-乙酰-β-D-氨基葡萄糖苷酶（NAG）浓度之间存在正相关，同时也发现砷和铬暴露与肾脏损伤分子（KIM-1）之间存在正相关。对研究的评估表明，砷、镉、铅和铬与蛋白尿和白蛋白尿之间存在关联，但与 CKD 结局无关。目前的系统研究表明，通过饮用水暴露于砷、镉、铅和铬与肾脏问题的发生之间几乎没有关联。然而，需要更多的流行病学研究来证实这种关联。
