Abstract
The traditional causes of Chronic Kidney Damage (CKD) are Diabetes and Hypertension. However, recent studies reported the possible relations between metal exposure and CKD. This study aims to explore the status of metals in CKD patients compared to their healthy counterparts at Narayanganj, Bangladesh, through a cross-sectional study. In this study, 50 volunteers were involved; 30 CKD patients and 20 healthy controls. Five metals were measured from serum [Copper (Cu) and Zinc (Zn)] and urine [Lead (Pb), Cadmium (Cd), and Chromium (Cr)] using Atomic Absorption Spectrometry. Compared to the controls the CKD patients exhibited significantly higher levels of Pb, Cd and Cr levels in their urine samples. This signifies a potential association between heavy metal exposure and CKD. The serum levels of Cu were much higher than expected for CKD patients than controls, and the Zn values were in accordance with established literature. However, the level of Zn in blood was significantly lower in the CKD group compared to the control. This data suggests that the Cu imbalance in the serum of the CKD subjects might have been related to a myriad of reasons, the most plausible of which being exposed to large concentrations of the nephrotoxic metals such as Pb, Cd and Cr in this study. Our study has shed a much needed light on the correlation between CKD and exposure to heavy metals and imbalance of essential metals in blood serum, in a rural locality of Bangladesh.
Highlights
Bangladesh mainly has an agro-based economy with limited land to feed up a large population
Some studies reveal a possible correlation of Chronic Kidney Damage (CKD) with heavy metals, it has not been established for low-level environmental exposure (Jayasumana et al, 2015)
Excess fertilizer use, continued irrigation from the rivers have lead to an ecosystem rich in toxic heavy metals.It has been described that the river water, sediment, and fish from the Buriganga and Shitalakshya are highly contaminated with Cadmium, Lead, Chromium, and Arsenic (Islam et al, 2018)
Summary
Bangladesh mainly has an agro-based economy with limited land to feed up a large population. It has been reported that toxic metals in fertilizers and pesticides might attribute to Chronic Kidney Damage (CKD) (Jayasumana et al, 2015). Some studies reveal a possible correlation of CKD with heavy metals, it has not been established for low-level environmental exposure (Jayasumana et al, 2015). The correlation of metals and CKD incidence still needs to be explored as minimal research has been done and presented very mixed findings to explain the CKD etiology. Kim et al (2015) reported in an epidemiological study that Pb, Hg, and Cd in blood were not associated with CKD, while Cd is associated in CKD cases having comorbidities such as hypertension or diabetes (Kim et al, 2015). The descriptive studies found elevated Cd and Pb levels in CKD populations (Moody et al, 2018)
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