Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Dec 6;8(20):181202.
doi: 10.5696/2156-9614-8.20.181202. eCollection 2018 Dec.

Role of Toxic Elements in Chronic Kidney Disease

Adwalia Fevrier-Paul  1 , Adedamola K Soyibo  2 , Sylvia Mitchell  3 , Mitko Voutchkov  1
Affiliations
Review

Role of Toxic Elements in Chronic Kidney Disease

Adwalia Fevrier-Paul et al. J Health Pollut. .

Abstract

Background: The kidney is central to many complex pathways in the body and kidney injury can precipitate multiple negative clinical outcomes. The resultant effect on nutrition and elemental body burden is bi-directional, confounding the very complex pathways that maintain homeostasis. These elemental changes themselves increase the risk of nutritional and biochemical disturbances.

Objectives: The aim of the present study was to describe how toxic elements interface with complications of chronic kidney disease (CKD).

Methods: The present review included studies focusing on the molecular mechanisms induced by exposure to elements with known nephrotoxic effects and associated health complications in CKD patients.

Discussion: Many non-essential elements have nephrotoxic activity. Chronic injury can involve direct tubular damage, activation of mediators of oxidative stress, genetic modifications that predispose poor cardiovascular outcomes, as well as competitive uptake and element mobilization with essential elements, found to be deficient in CKD. Cardiovascular disease is the most common cause of mortality among CKD patients. Oxidative stress, a common denominator of both deficient and excess element body constitution, underlies many pathological derivatives of chronic kidney disease. Bone disorders, hematological dysfunction and dysregulation of acid-base balance are also prevalent in kidney patients. The largest contribution of toxic element body burden results from environmental exposure and lifestyle practices. However, standard medical therapies may also potentiate toxic element accumulation and re-injury of vulnerable tissue.

Conclusions: For CKD patients, the cumulative effect of toxic elements persists throughout the disease and potentiates complications of CKD. Medical management should be coordinated between a medical team, dietitians and clinical researchers to mitigate those harmful effects.

Competing interests: The authors declare no competing financial interests.

Keywords: Complications of chronic kidney disease; kidney function; minerals; nutrition.

PubMed Disclaimer

References

    1. Lingameneni Prasanth KMK, Ravi Teja Chitturi, Venkat Ramana Meddy Baddam, Lingamaneni Krishna Prasad. A review on role of essential trace elements in health and disease. Dr NTR University Health Sciences. 2015;4(2):75–85.
    1. Hall J. Guyton & Hall Textbook of Medical Physiology. 12 ed. Philadelphia, PA: Elsevier; 2011.
    1. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Kidney International Supplements. 2012;2(4)
    1. Sabath Ernesto MLR-O. Renal health and the environment: heavy metal nephrotoxicity. Nefrologia. 2012;32(3):279–286. - PubMed
    1. Joseph Lunyera DM, Von Isenburg Megan, Jeuland Marc, Patel Uptal D, Stanifer John W. CKD of Uncertain Etiology: A Systematic Review. Clinical journal of the American Society of Nephrology. 2015;11 - PMC - PubMed

LinkOut - more resources