Clinical and biological profile and factors associated with high blood lead levels in chronic hemodialysis patients in a western French Guiana Hospital Center

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Objective: The objective of this study is to describe the clinical and biological profile and identify factors associated with elevated blood lead levels (BLLs) in chronic hemodialysis (HD) patients in western French Guiana.Materials and methods: A cross-sectional analytical study was conducted in December 2022 among 65 chronic HD patients.BLLs were measured, and hyperleademia was defined as a BLL > 85 µg/L.Clinical, biological, and dialysis-related parameters were collected.Multivariate logistic regression was used to identify factors independently associated with elevated BLLs (p < 0.05).Results: Elevated BLLs were observed in 35 patients (54%), with a median BLL of 120 µg/L.Patients with high BLL were older and had lower residual urine output.In multivariate analysis, older age, higher serum albumin, lower total protein, and lower phosphate levels were independently associated with elevated BLL, while female sex was inversely associated.Vintage dialysis, dialysis adequacy, and erythropoiesis-stimulating agent dose were not independently associated with elevated BLL.Conclusion: Elevated BLLs are common in chronic HD patients in western French Guiana and are associated with older age, altered nutritional markers, and reduced residual renal function (RRF), whereas female sex appears to be protective.These findings support the need for routine BLL screening in at-risk dialysis populations, careful monitoring of nutritional status, and strategies aimed at preserving RRF.

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