PMID: identifier of
Pubmed reference: |
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 (17135394) |
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| title: |
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Effect of organic solvent exposure on chronic kidney disease progression: the GN-PROGRESS cohort study. |
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| author(s): |
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Sophie Jacob ( ) 1, Michel Héry2, Jean-Claude Protois2, Jérôme Rossert3, 4, Bénédicte Stengel1 |
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| laboratory: |
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| short title : |
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Solvent Exposure and Kidney Disease Progression |
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| abstract: |
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It has been suggested that solvent exposure may have a role in the progression of glomerulonephritis (GN) to ESRD, but this has never been tested with an appropriate cohort study design. A total of 338 non-ESRD patients with a first biopsy for primary GN between 1994 and 2001 were included: 194 IgA nephropathies (IgAN), 75 membranous nephropathies (MN), and 69 FSGS. ESRD, defined as an estimated GFR <15 ml/min per 1.73 m2 or dialysis, was registered during a mean follow-up period of 5 yr. Patients' lifelong solvent exposures before and after diagnosis were recorded by interview and assessed by industrial hygienist experts. Cox models were used to estimate adjusted hazard ratios (HR) of ESRD related to exposures. Overall, 15 and 14% of the patients had been exposed at a low and a high level before diagnosis, respectively. Forty-two with IgAN, 12 with MN, and 22 with FSGS reached ESRD. A graded relationship was observed for MN (age- and gender-adjusted HR [95% confidence interval] for low exposure versus none was 3.1 [0.5 to 18.2] and for high exposure versus none was 8.2 [1.9 to 34.7]) and for IgAN (1.6 [0.7 to 3.9] and 2.2 [1.0 to 4.8]) but not for FSGS. Solvent risk was mediated only partly by baseline proteinuria: Adjusted HR for high exposure versus none was 5.5 (1.3 to 23.9) for MN and 1.8 (0.8 to 3.9) for IgAN. In patients with IgAN, there was a trend in increasing HR with exposure duration before and its persistence after diagnosis. These findings support the hypothesized association of solvent exposure with the progression of GN to ESRD. They should prompt clinicians to give greater attention to patients' occupational exposures and possibly to consider professional reclassification. |
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| subject: |
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| fulltext language: |
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English |
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| ISSN: |
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1046-6673 |
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| publication format: |
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Article in peer-reviewed journal |
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| DOI: |
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10.1681/ASN.2006060652 |
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| journal: |
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J Am Soc Nephrol |
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| publication date: |
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2007-01 |
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| submission date: |
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2006-11-29 |
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| volume: |
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18 |
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| issue: |
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1 |
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| page, identifiant, ...: |
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274-81 |
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| keyword(s) of author: |
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Organic solvents – glomerulonephritis – membranous nephropathy – IgA nephropathy – focal and segmental glomerulosclerosis – end stage renal disease – environmental exposure |
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| contract, financing: |
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Ministère de la Santé (PHRC AOM 00022) Ministère de l'Environnement (Décision d'aide EN00D08) Ministère de la Recherche (Décision d'aide 01P0513) Agence de Biomédecine (AO Recherche et Greffes 2005) Agence de l'Environnement et de la Maitrise de l'Energie - ADEME (Bourse de thèse) |
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