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Renal tubular dysfunction in children living in the Aral Sea Region
  1. K Kaneko1,
  2. M Chiba2,
  3. M Hashizume3,
  4. O Kunii3,
  5. S Sasaki4,
  6. T Shimoda5,
  7. Y Yamashiro1,
  8. W Caypil6,
  9. D Dauletbaev7
  1. 1Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan
  2. 2Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Tokyo, Japan
  3. 3Department of International Community Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  4. 4Scientific evaluation of Dietary Reference Intakes, National Institute of Health and Nutrition, Tokyo, Japan
  5. 5Faculty of Home Economics, Kyushu Women’s University, Kitakyushu, Japan
  6. 6Department of Biochemistry, Kazakh State Medical University, Kazakhstan
  7. 7Ministry of Health, Kzyl-Orda, Kazakhstan, Kazakhstan
  1. Correspondence to:
    Dr K Kaneko
    Department of Pediatrics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113 8421, Japan;


Background: The Aral Sea region is a natural area seriously polluted by human activities. Recent surveillance revealed the increased prevalence of diverse chronic diseases in children.

Aims: To investigate the function of renal tubules, which are most at risk of damage as a result of heavy metal intoxication, in children of the Aral Sea region.

Methods: A group of 205 children living in Kazalinsk, close to the Aral Sea, and a group of 187 children living in Zhanakorgan, far from the Aral Sea, were examined by means of random urine samples. Both urinary N-acetyl-β-d-glucosaminidase (NAG; U/mmol Cr) and β2 microglobulin (BMG; μg/mmol Cr) were calculated for each subject.

Results: Mean urinary NAG and BMG were both significantly higher in Kazalinsk than in Zhanakorgan (NAG: 0.77 (0.58) and 0.62 (0.37) U/mmol Cr; BMG: 41.8 (54.8) and 22.5 (20.4) μg/mmol Cr, respectively; mean (SD), p < 0.01). The number of children with abnormal values of NAG (>1.5 U/mmol Cr) was significantly more prevalent in Kazalinsk than in Zhanakorgan (7.9% and 2.6%, respectively, p < 0.05).

Conclusion: Renal tubular function of children around the Aral Sea region is profoundly impaired. This should be taken into account when considering the health problems of this area.

  • Aral Sea
  • renal tubular function
  • NAG
  • β2-microglobulin
  • BMG, β2 microglobulin
  • Cr, creatinine
  • NAG, N-acetyl-β-d-glucosaminidase
  • PCB, polychlorinated biphenyl

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