Extract
Residential proximity to hazardous waste sites and risk of end-stage renal disease.
Introduction
End-stage renal disease (ESRD) is characterized by total renal failure making hemodialysis or organ transplantation necessary. Some ESRD can be explained by underlying disease processes such as diabetes mellitus or polycystic kidney disease (1). The etiologic origin of many of the remaining ESRD cases has not been determined and might be of environmental origin. Environmental exposures that have been linked to chronic renal failure include exposures to hydrocarbons and metals. Occupational lead exposures in battery plant workers, lead production or smelter workers, and workers involved in sandblasting of surfaces painted with lead (2-6) have been associated with ESRD. High-level lead exposures in childhood (7,8) and consumption of "moonshine" (presumably contaminated with lead) have been linked to ESRD as well (9). Lead can have a direct effect on the kidneys or an indirect effect through increased blood pressure. Higher body burdens of lead have been found in patients with chronic renal failure than in control patients (10,11). Cadmium reaches the highest body concentrations in the renal cortex and has been associated with renal dysfunction (12). Human studies were based on occupational exposures an...See the full content of this document
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