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The association of clinical findings and exposure profiles with melamine associated nephrolithiasis
  1. I-Jen Wang (r92846001{at}ntu.edu.tw)
  1. Taipei Hospital, Department of Health; China Medical University, Taiwan
    1. Yu-Nian Wu (ped56{at}ptph.doh.gov.tw)
    1. Department of Pediatrics, Taipei Hospital, Department of Health, Taiwan
      1. Wen-Chiuo Wu (ped74{at}ptph.doh.gov.tw)
      1. Department of Pediatrics, Taipei Hospital, Department of Health, Taiwan
        1. Giovanni Leonardi
        1. Health Protection Agency, Centre for Radiation, Chemical, and Environmental Hazards, Chemical Hazard, United Kingdom
          1. Yen-Jen Sung
          1. Institute of Cell Biology and Anatomy, National Yang Ming University, Taiwan
            1. Tien-Jen Lin (trlin{at}hotmail.com)
            1. Taipei Medical University, Wan Fang Hospital, Taiwan
              1. Chiung-Lang Wang
              1. Taipei Hospital, Department of Health, Taiwan
                1. Charng-Fong Kuo
                1. Taipei Hospital, Department of Health, Taiwan
                  1. Kuen-Yuh Wu
                  1. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taiwan
                    1. Wei-Chih Cheng
                    1. Bureau of Food and Drug Analysis, Department of Health, Taiwan
                      1. Chang-Chuan Chan
                      1. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taiwan
                        1. Pau-Chung Chen
                        1. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taiwan
                          1. Shoei-Loong Lin (d94841002{at}ntu.edu.tw)
                          1. Taipei Hospital, Department of Health, Taiwan

                            Abstract

                            Background: Little is known about the exposure profiles of melamine in children. We evaluated the association of clinical findings, exposure patterns, and biomarkers with nephrolithiasis in children with potential exposure to melamine.

                            Methods: A case control study was conducted in children aged 0 to 16 years with potential exposure to contaminated dairy products. Cases were defined as nephrolithiasis detected by renal ultrasonography. On the basis of different brands of contaminated dairy products consumed, subjects were classified into high exposure, low exposure, and control groups with estimated melamine exposure levels of higher than 2.5ppm, 0.05-2.5ppm, and lower than detection limits <0.05ppm. We measured urine melamine for those with nephrolithiasis and age- and gender-matched controls within the subset of the study population.

                            Results: The duration of contaminated products consumption was longer in children with nephrolithiasis in the high exposure group than controls [median (IQR) 12.0 (3.3-24.0) vs. 6.0 (4.0-7.0) months; p=0.048]. High melamine exposure levels were significantly associated with nephrolithiasis [OR: 61.04 (95%CI: 12.73-292.84)]. The risk was found to increase with estimate melamine exposure levels (p for trend <0.001). Two among ten affected subjects with nephrolithiasis showed elevated urine melamine levels .In comparison, levels of all twenty controls were lower than the detection limit.

                            Conclusions: The risk of melamine associated nephrolithiasis was related with duration of contaminated products consumption and estimate melamine exposure levels. Though urine melamine was not a sensitive test, it might serve as an exposure biomarker in melamine associated nephrolithiasis.

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