Association between Prenatal blood lead levels and reduced p
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The prenatal phase can be a crucial window to the risk of environmental insult leading to a permanent nephronic failure for the developing kidney. Because the bulk of nephron formation is complete in the third quarter, we examined whether (1) a decreased preadolescent kidney function is correlated with prenatal lead exposure, and (2) if preadolescent obesity synergistically reduces exposure to early life to kidney.

This study included 453 mother–child pairs participating in the PROGRESS birth cohort. Researchers assessed prenatal blood lead levels (BLLs) in samples collected in the 2nd and 3rd trimesters and at delivery, as well as tibial and patellar bone lead measures assessed one-month postpartum.

Preadolescent estimated glomerular filtration rate (eGFR) was derived from serum levels of creatinine and/or cystatin C measured at age 8–12 years. Linear regression was applied to assess the relationship between prenatal bone and BLL with preadolescent eGFR, and adjusted for covariates including age, sex, BMI z-score, indoor tobacco smoke exposure, and socioeconomic status.

--Researchers observed null associations between prenatal lead exposure and eGFR. However, in interaction analysis researchers found that among overweight children, there was an inverse association between BLL (assessed at 2nd and 3rd trimester and at delivery) and preadolescent eGFR.

--Regardless of lead exposure, null relationships between BMI z-score and eGFR overall was also observed, as well as among overweight participants. However, among participants with preadolescent obesity, a significant 5.9-unit decrease in eGFR was observed.

Conclusively, a complex interplay is suggested between the combined adverse effects of adiposity and perinatal lead exposure as they relate to adolescent kidney function. Future studies will assess kidney function and adiposity trajectories through adolescence to better understand environmental risk factors for kidney function decline.