Renal effects of uranium in drinking water.
Renal effects of uranium in drinking water.
复制标题
DOI：
10.1289/ehp.02110337
复制
发表时间：
2002-04
影响因子：
10.4
通讯作者：
Komulainen, Hannu
中科院分区：
文献类型：
--
作者：
Kurttio, Paivi;Auvinen, Anssi;Salonen, Laina;Saha, Heikki;Pekkanen, Juha;Makelainen, Ilona;Vaisanen, Sari B;Penttila, Ilkka M;Komulainen, Hannu
动物研究和对人类的小型研究表明，铀具有肾毒性。然而，需要更多关于其在通过饮用水慢性暴露后对人类肾脏影响的信息。我们测量了325名使用钻井作为饮用水的人的饮用水和尿液中的铀浓度。我们测量了尿和血清中钙、磷、葡萄糖、白蛋白、肌酐和β-2-微球蛋白的浓度，以评估可能对肾脏的影响。饮用水中铀浓度的中位数为28微克/L(最大四分位数范围6-135)。每天铀摄入量的中位数为39微克(7-224)，尿中的肌酐为13 ng/mmor(2-75)。尿铀浓度与钙和磷排泄分数的增加在统计学上显著相关。尿铀每增加1微克/摩尔，钙的排泄分数增加1.5%[95%可信区间(CI)0.6-2.3]，磷酸盐排泄增加13%(1.4-25)，葡萄糖排泄增加0.7微摩尔/分钟(-0.4-1.8)。饮用水中的铀浓度和每日铀摄入量与钙的排泄有统计学意义上的相关性，但与磷酸盐或葡萄糖的排泄无关。铀暴露与反映肾小球功能的内生肌酐清除量或尿白蛋白无关。总而言之，在没有明确阈值的情况下，铀暴露与近端小管功能改变的相关性很弱，这表明即使饮用水中的低浓度铀也会导致肾毒性效应。尽管长期摄入高铀浓度的水，我们没有观察到对肾小球功能的影响。这些发现与临床和公共卫生的相关性并不容易建立，但我们的结果表明，饮用水中铀的安全浓度可能在建议的指导值2-30微克/L的范围内。
Animal studies and small studies in humans have shown that uranium is nephrotoxic. However, more information about its renal effects in humans following chronic exposure through drinking water is required. We measured uranium concentrations in drinking water and urine in 325 persons who had used drilled wells for drinking water. We measured urine and serum concentrations of calcium, phosphate, glucose, albumin, creatinine, and beta-2-microglobulin to evaluate possible renal effects. The median uranium concentration in drinking water was 28 microg/L (interquartile range 6-135, max. 1,920 microg/L) and in urine 13 ng/mmol creatinine (2-75), resulting in the median daily uranium intake of 39 microg (7-224). Uranium concentration in urine was statistically significantly associated with increased fractional excretion of calcium and phosphate. Increase of uranium in urine by 1 microg/mmol creatinine increased fractional excretion of calcium by 1.5% [95% confidence interval (CI), 0.6-2.3], phosphate by 13% (1.4-25), and glucose excretion by 0.7 micromol/min (-0.4-1.8). Uranium concentrations in drinking water and daily intake of uranium were statistically significantly associated with calcium fractional excretion, but not with phosphate or glucose excretion. Uranium exposure was not associated with creatinine clearance or urinary albumin, which reflect glomerular function. In conclusion, uranium exposure is weakly associated with altered proximal tubulus function without a clear threshold, which suggests that even low uranium concentrations in drinking water can cause nephrotoxic effects. Despite chronic intake of water with high uranium concentration, we observed no effect on glomerular function. The clinical and public health relevance of the findings are not easily established, but our results suggest that the safe concentration of uranium in drinking water may be within the range of the proposed guideline values of 2-30 microg/L.