Evaluations of toxic heavy metals lead and mercury in regular hemodialysis smoker and nonsmoker patients by comparison with other normal population in Egyptian population

Abstract

Around the population, worldwide, 10% are affected by chronic kidney disease (CKD); hemodialysis is the common choice of renal replacement therapy. Cigarette smokers have a high Lead level than the non-smoker population, as Tobacco leaf grew on polluted soil, and it is proven that Mercury poisoning depends on the dose and duration of exposure. The study aimed to determine two crucial toxic heavy metals elements Lead and Mercury concentrations in pre hemodialysis. Methodology: blood samples were collected from CKD patients on maintenance hemodialysis for more than six months divided into non-smoker and smoker to be compared with samples from a control group non-CKD, non-smoker persons. Our study was conducted in September 2019 in Al Mokattam insurance hospital – Cairo and involved 60 persons of both sexes. They were divided into three groups: CKD stage 5 patients on hemodialysis 40 patients and sub-divided into two groups; (smoker) 20 patients and (nonsmoker) 20 patients and the history of eating fish and seafood was taken. The third group was a control group, including 20 healthy non-smoker participants. Lead and Mercury were analyzed by electrothermal atomic absorption spectrophotometer in Al Borg central Laboratory. The complete blood count (CBC), kidney function tests, and Iron parameters were also detected. Results: prolonged duration on hemodialysis did not raise Lead or Mercury level in the blood, while smoking raises the Lead level in the blood, and eating fish and seafood more than once per week increased Mercury level in the blood. There was a relation between raised Lead level and anemia in hemodialysis patients. Conclusion: Lead and Mercury measurement is essential in hemodialysis patients with possible symptoms of heavy metal toxicity. Lead level monitoring is recommended in resistant anemia in hemodialysis patients.