Abstract: FR-PO408

Arsenic Exposure and Incident ESRD in the Southern Community Cohort Study (SCCS)

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Kabagambe, Edmond Kato, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Morse, Jennifer, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Stewart, Thomas G., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Bowman, Aaron B, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Zhang, Yaofang, Vanderbilt University, Nashville, Tennessee, United States
  • Blot, William J., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Lipworth, Loren, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background

Arsenic (As) is nephrotoxic at high doses. We hypothesized that long-term low to moderate exposure to As is associated with ESRD risk.

Methods

We conducted a nested case-control study within the SCCS, a prospective study of low income adults residing in underserved urban and rural communiities with potentially high toxicant burden in the southeastern US (2002-2009). Among 125 (63 black, 62 white) randomly selected incident ESRD cases and 250 controls, matched on age, race, sex and time of enrollment, baseline serum As was measured by inductively coupled plasma mass spectrometry. Data were modeled using conditional logistic regression, after log transformation of As. Generalized additive models examined the association of As exposure with ESRD probability adjusting for age, race, sex, diabetes, hypertension, and smoking.

Results

Mean age at SCCS enrollment of cases and controls was 55 years, and 55% were female. Median (25th, 75th percentile) levels of As (ng/ml) were significantly higher among ESRD cases (0.56; 0.32, 0.85) than among controls (0.39; 0.26, 0.73). An inter-quartile range increase in As log-transformed level was associated with significantly higher odds of ESRD (OR=1.58; 95% CI 1.21-2.06). The relative odds of ESRD as As varies from the median were computed from a multivariable logistic regression model controlling for hypertension, diabetes, enrollment age, race, sex, and smoking. The OR plotted against As (see Figure) shows the estimated association.

Conclusion

In summary, these results provide support for the hypothesis that chronic low to moderate exposure to As may be an important novel modifiable contributor to ESRD risk. Further work incorporating urinary As and geographic exposure modeling is ongoing.

Funding

  • Other NIH Support