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Kidney Week

Abstract: SA-PO594

Clinical and Biological Profile and Factors Associated with High Blood Lead Levels in Chronic Hemodialysis Patients in a Western French Guiana Hospital Center

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Author

  • Makembi, Arriel, Universite de Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
Background

Lead is toxic to the body. Its chronic intoxication combines various clinical and biological disorders that can be life-threatening. In French Guiana, lead poisoning is particularly worrying, as the incidence rate is nearly sixty times higher than in metropolitan France. In chronic hemodialysis patients, lead levels are often higher and can lead to several adverse consequences. Hence, the interest of this study, which is to describe the clinical and biological characteristics of chronic hemodialysis patients with high blood lead levels and to identify the associated factors to draw attention to its screening and the prevention of its complications.

Methods

Descriptive and analytical cross-sectional study that included 65 patients on chronic conventional hemodialysis: with an annual biological assessment in December 2022, including a serum lead assay. The outcome was the notion of hyper lead level, defined by a lead level > 85 μg/l. We described the clinical, biological, and dialytic parameters of patients with hyper lead levels and in logistic regression, we identified the factors that are correlated according to a significance threshold P<0.05.

Results

In total, 54% of patients had hyper lead levels, of which 2/3 were female. They were older, with an average age of 62. No patients had occupational exposure to lead. 94% were hypertensive and half were diabetic. 1/4 had anaemia and all had resistance to erythropoietin. Their ferritin levels were slightly lower, with an average of 721 μg/l. The mean albumin was 30 g/l, pre-albumin was 28 g/l, the mean parathyroid hormone was elevated at 1355 ng/ml, NT-pro BNP at 9144 ng/ml. The mean CRP was 10.8 mg/L. They had collapsed residual diuresis and natriuresis with averages of 150 ml and 12 mmol/24 hours, respectively. There was a significant positive correlation between elevated BLL and young age and negative correlation with female sex, low serum albumin, prealbumin, protein and ferritin levels, and collapsed residual diuresis.

Conclusion

High blood lead levels are common in the Guyanese chronic hemodialysis population in which it is correlated with female sex, malnutrition, iron deficiency and residual poor renal function and probably with resistance to erythropoietin treatment. It is necessary to screen in at-risk populations to prevent complications associated with it.