ArticleEnvironmental research2021
Urine tungsten and chronic kidney disease in rural Colorado.
Article in Environmental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Heterogeneity in diagnostic criteria for chronic kidney disease of undetermined etiology (CKDu): a systematic review of the literature.BMC nephrology · 2025Pooled it
- Exposomics as a discovery engine for emerging contaminants and hidden biological risks.Emerging contaminants · 2026Article
- Association of metal and metalloid exposure with cardiovascular-kidney-metabolic syndrome: mediation by inflammation, oxidative stress, and aging.BMC public health · 2025Article
- Article
- Associations between metals and metabolomic profiles related to diabetes among adults in a rural region.Environmental research · 2024Article
- Tungsten toxicity on kidney tubular epithelial cells induces renal inflammation and M1-macrophage polarization.Cell biology and toxicology · 2023Article
- Potential Roles of Metals in the Pathogenesis of Pulmonary and Systemic Hypertension.International journal of biological sciences · 2023Review
- Development and application of an evidence-based directed acyclic graph to evaluate the associations between metal mixtures and cardiometabolic outcomes.Epidemiologic methods · 2023Article
- Tungsten toxicity and carcinogenesis.Advances in pharmacology (San Diego, Calif.) · 2023Article
- Multipollutant, longitudinal analysis of the association between urinary tungsten and incident diabetes in a rural population.Environmental epidemiology (Philadelphia, Pa.) · 2021Article
- Climate and Kidney Injury: A Look at the Impact of Meteorological Factors on Kidney Function within Colorado.Weather, climate, and society (Print)Article
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7 authors.
Funding
Abstract
backgroundChronic kidney disease (CKD) is a cause of global morbidity and mortality in agricultural communities. The San Luis Valley (SLV) is a rural agricultural community in southern Colorado with geographic and sociodemographic risk factors for CKD, including a water supply contaminated by heavy metals.
methodsWe obtained pre-existing sociodemographic, clinical, and urine trace metal data for 1659 subjects from the San Luis Valley Diabetes Study, a prospective cohort study. We assessed prospective associations between urine tungsten (W) and time-to-CKD using accelerated failure time models (n = 1659). Additionally, logistic models were used to assess relationships between urine W and renal injury markers (NGAL, KIM1) using Tobit regression (n = 816), as well as epidemiologically-defined CKD of unknown origin (CKDu) using multiple logistic regression (n = 620).
resultsElevated urine W was strongly associated with decreased time-to-CKD, even after controlling for hypertension and diabetes. Depending on how CKD was defined, a doubling of urine W was associated with a 27% (95% CI 11%, 46%) to 31% (14%, 51%) higher odds of developing CKD within 5 years. The relationship between urine W and select renal injury markers was not significant, although urine NGAL was modified by diabetes status. Elevated (>95%ile) urinary W was significantly associated with CKDu (OR 5.93, 1.83, 19.21) while adjusting for known CKD risk factors.
conclusionsOur data suggest that increased exposure to W is associated with decreased time-to-CKD and may be associated with CKDu. Given persistence of associations after controlling for diabetes and hypertension, W may exert a primary effect on the kidney, although this needs to be evaluated further in future studies.
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