Table 4.
Mean difference in eGFR measures, in mL/min/1.73 m2, per each doubling of urine metal concentration, by urine concentration adjustment approach.
| Urine concentration adjustment method | |||
|---|---|---|---|
|
| |||
| β (95% CI) None | β (95% CI) Urine creatinine (mg/dL) | β (95% CI) Urine osmolality (μOsm/kg) | |
| Cadmium | CKiD bedside serum creatinine-based eGFR | ||
| Model 1 | −1.5 (−2.9, −0.1) | 2.3 (0.6, 3.9) | −0.7 (−2.3, 1.0) |
| Model 2 | −0.1 (−1.4, 1.2) | 3.0 (1.4, 4.5) | 0.4 (−1.1, 1.9) |
| Model 3 | −0.1 (−1.4, 1.2) | 2.8 (1.3, 4.4) | 0.3 (−1.2, 1.8) |
| Model 4 | −0.3 (−1.6, 1.1) | 3.1 (1.4, 4.8) | 0.1 (−1.5, 1.7) |
| Filler serum cystatin-C-based eGFR | |||
| Model 1 | −1.4 (−2.9, 0.1) | −1.0 (−3.0, 0.9) | −1.2 (−3.0, 0.6) |
| Model 2 | −0.4 (−1.7, 1.0) | 0.4 (−1.3, 2.1) | −0.9 (−2.5, 0.7) |
| Model 3 | −0.4 (−1.7, 1.0) | 0.4 (−1.3, 2.1) | −1.0 (−2.6, 0.6) |
| Model 4 | 0.4 (−1.0, 1.8) | 1.8 (0.0, 3.7) | 0.0 (−1.7, 1.7) |
| Thallium | CKiD bedside serum creatinine-based eGFR | ||
| Model 1 | −1.1 (−2.6, 0.5) | 3.2 (1.5, 5.0) | 1.9 (−0.3, 4.1) |
| Model 2 | −0.1 (−1.5, 1.4) | 3.6 (1.9, 5.3) | 2.0 (−0.1, 4.0) |
| Model 3 | 0.1 (−1.4,1.5) | 3.6 (1.9, 5.3) | 1.9 (−0.2, 4.0) |
| Model 4 | −0.0 (−1.5, 1.5) | 3.6 (1.8, 5.3) | 1.8 (−0.3, 3.9) |
| Filler serum cystatin-C-based eGFR | |||
| Model 1 | −2.6 (−4.2, −0.9) | −2.7 (−4.8, −0.6) | −3.9 (−6.3, −1.4) |
| Model 2 | −0.0 (−1.5, 1.5) | 1.1 (−0.8, 3.0) | −0.8 (−3.0, 1.4) |
| Model 3 | 0.1 (−1.4, 1.7) | 1.3 (−0.6, 3.2) | −0.7 (−2.9, 1.5) |
| Model 4 | 0.5 (−1.1, 2.0) | 1.9 (−0.0, 3.8) | −0.0 (−2.2, 2.2) |
| Uranium | CKiD bedside serum creatinine-based eGFR | ||
| Model 1 | −1.3 (−2.4, −0.2) | 1.5 (0.2, 2.8) | −0.6 (−1.9, 0.6) |
| Model 2 | −0.9 (−1.9, 0.1) | 1.2 (−0.0, 2.4) | −0.6 (−1.8, 0.5) |
| Model 3 | −0.9 (−2.0, 0.1) | 1.1 (−0.2, 2.4) | −0.8 (−1.9, 0.4) |
| Model 4 | −1.0 (−2.0, 0.1) | 1.1 (−0.2, 2.3) | −0.8 (−2.0, 0.3) |
| Filler serum cystatin-C-based eGFR | |||
| Model 1 | −1.8 (-3.0, −0.6) | −1.9 (−3.4, −0.3) | −1.8 (−3.2, −0.4) |
| Model 2 | −0.3 (−1.4, 0.8) | 0.3 (−1.1, 1.6) | −0.6 (−1.8, 0.6) |
| Model 3 | −0.1 (−1.2, 1.0) | 0.6 (−0.8, 2.0) | −0.4 (−1.7, 0.7) |
| Model 4 | 0.0 (−1.1, 1.1) | 0.9 (−0.5, 2.3) | −0.2 (−1.5, 1.0) |
Model 1: Crude (independent variables include only urine metal [ln (metal)/ln (2)] and urine creatinine or osmolality [added in last two columns] as separate co-variates.
Model 2: Adjusted for Model 1 co-variates, age, and sex.
Model 3: Adjusted for Model 2 co-variates, BMI, maternal education (none/primary, secondary, >secondary), monthly household income (<3000 pesos, ≥3000 pesos, unknown/no response), participant smoking status (never, former [not in past month], current [at least once in past month]), and systolic blood pressure.
Model 4: Adjusted for Model 3 co-variates and natural log blood lead. β reflects ml/min/1.73 m2 in eGFR for a doubling in metal concentration.