Kremer Daan, Riemersma Niels L, Groothof Dion, Sotomayor Camilo G, Eisenga Michele F, Post Adrian, Knobbe Tim J, Touw Daan J, Bakker Stephan J L
Department of Internal Medicine, Division of Nephrology, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago 8380453, Chile.
J Clin Med. 2022 Apr 1;11(7):1970. doi: 10.3390/jcm11071970.
The nephrotoxic effects of heavy metals have gained increasing scientific attention in the past years. Recent studies suggest that heavy metals, including cadmium, lead, and arsenic, are detrimental to kidney transplant recipients (KTR) even at circulating concentrations within the normal range, posing an increased risk for graft failure. Thallium is another highly toxic heavy metal, yet the potential consequences of the circulating thallium concentrations in KTR are unclear. We measured plasma thallium concentrations in 672 stable KTR enrolled in the prospective TransplantLines Food and Nutrition Biobank and Cohort Study using inductively coupled plasma mass spectrometry. In cross-sectional analyses, plasma thallium concentrations were positively associated with kidney function measures and hemoglobin. We observed no associations of thallium concentration with proteinuria or markers of tubular damage. In prospective analyses, we observed no association of plasma thallium with graft failure and mortality during a median follow-up of 5.4 [interquartile range: 4.8 to 6.1] years. In conclusion, in contrast with other heavy metals such as lead, cadmium, and arsenic, there is no evidence of tubular damage or thallium nephrotoxicity for the range of circulating thallium concentrations observed in this study. This is further evidenced by the absence of associations of plasma thallium with graft failure and mortality in KTR.
在过去几年中，重金属的肾毒性作用日益受到科学界的关注。最近的研究表明，包括镉、铅和砷在内的重金属，即使在循环浓度处于正常范围内，对肾移植受者（KTR）也是有害的，会增加移植失败的风险。铊是另一种剧毒重金属，然而KTR中循环铊浓度的潜在后果尚不清楚。我们使用电感耦合等离子体质谱法测量了参与前瞻性移植线食品与营养生物样本库及队列研究的672名稳定KTR的血浆铊浓度。在横断面分析中，血浆铊浓度与肾功能指标和血红蛋白呈正相关。我们未观察到铊浓度与蛋白尿或肾小管损伤标志物之间的关联。在前瞻性分析中，在中位随访5.4年[四分位间距：4.8至6.1年]期间，我们未观察到血浆铊与移植失败和死亡率之间的关联。总之，与铅、镉和砷等其他重金属不同，在本研究观察到的循环铊浓度范围内，没有证据表明存在肾小管损伤或铊肾毒性。KTR中血浆铊与移植失败和死亡率之间缺乏关联进一步证明了这一点。
