NICU-Based Lead Exposure

NICU-Based Lead Exposure and Biomarkers of Impaired Renal Health

Preterm infants are particularly susceptible to renal damage, because birth occurs prior to the completion of nephron formation fewer nephrons or impaired nephron function potentially alters the life-long renal health trajectory. NICU-Based Lead Exposure and Biomarkers of Impaired Renal Health was a project awarded to principal investigator Alison P. Sanders, PhD this past October. Dr. Sanders received $25,000 to investigate emerging evidence that suggests renal disease can develop from subclinical insults in fetal life or early childhood.

Dr. Sanders is joined by a team of co-investigators, including CEHC faculty Robert Wright, MD, MPH, Chris Gennings, PhD, Annemarie Stroustrup, MD, and Professor and Chair of Pediatrics Lisa Satlin, MD, and Associate Professor of Pediatrics and Newborn Medicine Andrea Weintruab, MD.  The team will further analyze critical periods for any differentiation of the renal filtration, secretion, and reabsorptive systems for environmental exposures that may alter the developmental trajectory of the kidney resulting in hypertension and renal disease.

alison-sanders“We recently noted that prenatal Pb exposure among preterm infants is associated with increased blood pressure at 4 years of age. We also know that, unexpectedly, Pb exposure is common in the NICU environment. We propose to build upon these important findings by measuring prenatal and NICU-based Pb exposure and examining both clinical AND preclinical biomarkers of renal dysfunction among a susceptible population of preterm infants. We hypothesize that early life Pb exposure contributes to renal dysfunction in preterm infants.”

– Alison P. Sanders, PhD.

The team is poised to address the impact of prenatal and early childhood Pb exposure during critical windows of renal development using the NICU Hospital Exposures and Long-Term Health cohort (NICU-HEALTH). Preterm infants born between 28 and 33 weeks gestation are enrolled in NICU-HEALTH and followed through early childhood. Using maternal blood and neonatal urine samples to measure Pb and selected biomarkers of renal dysfunction, along with a collection of other renal parameters (serum creatinine and blood pressure), Dr. Sanders analyzes associations between Pb exposure and renal outcomes individually and in combination.

Through the end of September 2017, the team hopes to inform an understanding of biomarkers for subclinical renal toxicity, and identify risk factors for early life origins of kidney disease and hypertension, potentially leading to future interventions designed to prevent or treat nephrotoxic Pb exposure in susceptible populations.