Abstract: PUB374
Heavy Metal-Related Chronic Obstructive Pulmonary Disease-Induced Kidney Dysfunction
Session Information
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Wu, Da-Wei, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan
- Hsu, Yu-Ming, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan
- Lu, Tzongshi, Brigham and Women's Hospital, Boston, Massachusetts, United States
Background
Heavy metals, including vanadium (V), chromium (Cr), cobalt (Co), cesium (Cs), and cadmium (Cd), represent significant environmental pollutants that exacerbate both chronic obstructive pulmonary disease (COPD) and impaired renal function. Concurrently, heavy metals accumulate in the kidneys due to their involvement in the excretion of these toxins, resulting in renal oxidative damage, inflammation, and nephrotoxicity. Furthermore, prior research demonstrates that individuals suffering from acute exacerbations of chronic obstructive pulmonary disease (AECOPD) experience a notably elevated incidence and prevalence of acute kidney injury (AKI). Patients with COPD who experience AKI during exacerbations often develop multiple comorbidities, placing extra burdens on health insurance and healthcare systems. Chronic kidney disease (CKD) commonly occurs in COPD patients, with prevalence rates reaching 43%.
Methods
A cohort of 150 patients from Kaohsiung, a unique global pattern of heavy metal pollution related to PM2.5, steelmaking, and the petrochemical industry, area with COPD was analyzed, with a mean age of 66.8 years and a mean Body Mass Index (BMI) of 25.5, indicating a mildly overweight population. Analyzing urine samples using advanced omics technologies to evaluate biomarkers such as neopterin, IP-10, CRP, and the specific kidney injury marker, Kidney injury molecule-1(KIM-1), and uncover metabolite profiles.
Results
Our data indicates that urinary heavy metal concentrations demonstrate significant differences across heavy metal exposure level groups (p < 0.05) in cases of COPD-induced renal dysfunction. Notably, cobalt (p=0.008), copper (p=0.038), and nickel (p=0.024) exhibit significantly elevated levels in the urine samples of the COPD-renal injury cohort. Moreover, we analyzed our data stratified by zip code, revealing that nickel (p=0.007) and manganese (p=0.005) also display significant increases within the COPD-renal injury group.
Conclusion
Our data suggests that heightened urinary concentrations of heavy metals are significantly correlated with diminished pulmonary function and augmented symptom severity in patients suffering from COPD. This emphasizes the pivotal role of heavy metal exposure in the progression of the disease and underscores the necessity for targeted strategies aimed at mitigation.
Funding
- Private Foundation Support