Table 3.

Association of CKD (eGFR<60 ml/min per 1.73 m2) with levels of lead in blood and urine

OutcomeAdjusted Difference in Blood and Urinary Lead Levels in Those with CKD Compared with Normal Renal Function
NHANES 1999–2002aNHANES 2017–2020b
Cystatin 2012CKD-EPI 2021 Using CreatinineCKD-EPI 2021 Using Creatinine/Cystatin CCKD-EPI 2021 Using Creatinine
Whole blood lead level, μg/dl0.23 (0.03 to 0.42)0.31 (0.09 to 0.53)0.19 (–0.02 to 0.4)0.12 (0.03 to 0.22)
Whole blood level in those with urinary lead levels, μg/dl0.21 (–0.04 to 0.47)0.1 (–0.26 to 0.46)0.11 (–0.13 to 0.36)0.22 (0.03 to 0.42)
Urinary lead, ng/ml−0.16 (–0.3 to –0.01)–0.18 (–0.34 to –0.03)–0.18 (–0.3 to –0.06)0.003 (–0.079 to 0.085)
Urinary lead/ creatinine ratio−0.003 (–0.004 to –0.001)–0.003 (–0.004 to –0.002)–0.003 (–0.004 to –0.002)0.00004 (–0.00058 to 0.00066)
  • NHANES, National Health and Nutrition Examination Survey.

  • a Adjusted for age, sex, race and ethnicity, number of household occupants, monthly income, citizenship.

  • b Adjusted for age, sex, race and ethnicity. All models are use strata (sdmvstra) and cluster (sdmvpsu) variables. Urinary measures use 4-year heavy metal weights (wtshm4yr). 2017–2020 cohort use MEX exam weights (wtmecprp) for all outcomes.