There are currently more than 50,000 individuals in the United States on Maintenance dialysis for end stage renal disease at a cost of more than $1.5 billion per year. There are also an unknown, but probably substantial, number of additional persons with renal dysfunction requiring some medical attention. Despite the magnitude of this health problem, chronic renal disease has received little attention in epidemiologic studies. The physiology and function of the kidneys are such that they are a likely target for detrimental effects of exposure to environmental hazards. Reports from diverse sources suggest that the kidney is sensitive to a wide variety of environmental exposures including lead, cadmium, chlorinated hydrocarbons, other solvents and metals, and analgesic medications. Two case-control studies are intended to evaluate the importance of several exposures that are suspected as causes of chronic renal disease. Data collection for a multi-center study of over 500 patients with newly diagnosed chronic renal failure and over 500 population controls has been completed. Exposure histories were obtained by telephone interview. Preliminary results suggest that both analgesic use and solvent exposure may increase risk for certain forms of chronic renal disease. These findings support other reports, but the detailed nature of this study will allow for more careful evaluation of exposure histories and confounding factors. Data collection has also been completed for an interview study involving approximately 50 patients with biopsy diagnosed IgA nephropathy and 90 controls. Preliminary results suggests that while patients with IgA disease were not more likely to report allergic conditions, they were, as hypothesized, more likely to report frequent colds and more frequent use of antibiotics. A striking but unexpected finding is that cases appear to be much more likely than controls to report use of artificial sweeteners.
