Evaluation of heavy metal and trace element levels in patients with proteinuria

OBJECTIVE: When the presence of proteinuria cannot be prevented, it is an important risk factor for the development of renal and cardiovascular diseases. Proteinüri şiddeti morbidite ve mortalite ilişkilidir. Bilindiği üzere böbrek ağır metallerin hedef organıdır. En sık hasarlanma yeri proksimal tübüler hücrelerdir. Bu hücreler toksik maddelere, plazma veya ekstraselüler sıvıdakilerden daha yuksek konsantrasyonda maruz kalırlar. Çalışmamızda, proteinüri hastalarında ağır metal ve eser element düzeylerinin plazma ve idrar seviyelerinin tespiti ve kontrol grubu ile kıyaslanması amaçlanmıştır. MATERIAL AND METHOD: A total of 99 people, 54 in the proteinuria group and 55 in the control group, were included in our study. Demographic data such as age and gender and biochemical parameters of the patients were evaluated. Arsenic (As), lead (Pb), mercury (Hg), cadmium (Cd), cobalt (Co), nickel (Ni), zinc (Zn), manganese (Mn), copper (Cu), chromium Cr and aluminum (Al) values were measured in plasma and urine and data were compared between the two groups. RESULTS: In the proteinuria group; As, Pb, Hg, Cd, Co, Ni and Mn concentrations were found to be significantly higher in both plasma and urine (p=0.001 for each metal). In the control group, only Zn and Cr values were found to be significantly higher in plasma and urine (p=0.001). CONCLUSION: While an increase in heavy metal levels may be observed in proteinuria cases, these patients are also at serious risk for deficiencies of trace metals such as Zn. Increase in heavy metal levels or trace element deficiencies accelerate the progression to chronic renal failure. Heavy metals and trace elements should be the parameters to be kept in mind in clinical follow-up, especially in risky individuals and those with clinical symptoms, or in cases where kidney damage progresses rapidly while blood pressure or blood sugar is regulated, sometimes liver failure develops, and consciousness is affected. If necessary, levels should be determined and chelation therapy should be given.