Trace Elements and Chronic Kidney Disease: A Cross-Sectional Study from Jamaica

Abstract

Background: Several environmental studies have reported that low-level exposure to nephrotoxic elements increases the risk of chronic kidney disease (CKD). In developing countries, finite resources can limit epidemiological studies and environmental risk assessment; however, the unique soil profile in Jamaica has raised some concerns for the potential exposure to populations who are of high risk. Method: This study investigated the potential for using trace element profiling in CKD, by analysing blood concentration levels of vanadium, chromium, iron, cobalt, copper, zinc, selenium, strontium (Sr), arsenic, barium, cadmium, mercury, and lead. Trace element analysis was conducted using inductively coupled plasma mass spectrometry. Results: One hundred and fifty-eight individuals were included and were predominantly of African descent (98%) and their ages ranged from 21 to 90 years old. Three main correlation clusters were evident: firstly, vanadium, chromium, copper, silicon, and selenium, with mercury and barium more distantly related; secondly, lead, arsenic, nickel, and Sr; and thirdly, iron and zinc. Cadmium was an outlier. Blood Sr was strongly associated with estimated glomerular filtration rate (r = -0.83; p<0.001) and strong linear progression models (r2=0.96; p<0.001). Algorithmic models placed Sr as the highest-ranking trace element biomarker (area under the curve: 95.6%; p<0.001). Discussion: The decline in kidney function may result in the retention of non-essential trace elements. Strong corresponding trends between kidney function and blood Sr concentration indicate biomarker potential for a trace element with a unique profile in patients with CKD. Other significant relationships may also be unveiled as CKD biomarkers as trace element profiling is explored in the region.