ATSDR has developed a test battery to examine early indicators of kidney dysfunction in several health investigations of persons who live near hazardous waste sites. However, little longitudinal data was available to determine the predictive value of these biomarkers in epidemiologic studies. The purpose of this study was to determine whether elevations in urinary kidney biomarkers (alanine aminopeptidase, n-acetyl-B-D-glucosaminidase, albumin, and retinol-binding protein) could be reversed over time, and to assess the value of these four biomarkers as predictors for the development of kidney disease. In 1998, ATSDR followed-up and retested 526 individuals who participated in one of three studies originally conducted in 1993 and 1994. At baseline, the participants were aged 8-75 years, and the follow-up occurred approximately 4.5 years later (range 3.6-5.1 years). For most of the children and adolescents, measured elevations in the kidney biomarkers had reverted to normal at follow-up. For persons aged 20 years or more, the presence or absence of elevated biomarkers at baseline among generally healthy participants was not associated with indicators of kidney disease at follow-up. However, participants who at baseline had 1) selected health conditions (diabetes, and to a lesser extent, heart disease, hypertension, gout, and urinary tract disease) and 2) elevated biomarkers were more likely at follow-up to show early indicators of kidney disease (elevated serum creatinine, elevated serum cystatin C, and decreased creatinine clearance). This longitudinal study confirmed the utility of these four tests as markers of preclinical kidney dysfunction among adults with certain pre-existing medical conditions.
Learning Objectives: N/A
Keywords: Environmental Health, Epidemiology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.