Low-level lead exposure and renal function in the Normative Aging Study.

Occupational and environmental lead exposure has been associated with significant impairment in renal function. The authors studied the cross-sectional relation between creatinine clearance and blood lead concentration in a population of 744 men participating in the Normative Aging Study of the Department of Veterans Affairs between July 1988 and April 1991. These men, aged 43-90 years, were recruited from communities in the Greater Boston, Massachusetts, area and were selected without regard to lead exposure. The mean values for blood lead concentration and creatinine clearance rate were 8.1 micrograms/dl (standard deviation, 3.9 micrograms/dl) and 88.2 ml/minute (standard deviation, 22.0 ml/minute), respectively. Independent relations of creatinine clearance to blood lead were assessed by multivariate linear regression analysis, with adjustment for various potential confounders. In multivariate linear regression models, the rate of creatinine clearance was significantly and negatively associated with increasing levels of blood lead, even after adjustment for age, body mass index, and use of diuretic and analgesic medications (the beta-coefficient for ln blood lead measured in microgram[microgram/dl]-1 was -0.030; standard error = 0.014, p = 0.037). A rise in ln blood lead of 10.0 micrograms/dl was associated with a decrease in the ln creatinine clearance rate of 10.4 ml/minute. These results support the hypothesis that exposure to low-level environmental lead correlates with a significant decrement in renal function.