Kidney disease and silicosis

Aim: To determine the prevalence of kidney disease in a cohort of individua ls with silicosis, Methods: Review of medical records and questionnaires fr om patients reported to a state surveillance system for silicosis, Reportin g of individuals with silicosis is required by state law, All individuals w ith silicosis reported as required by law to the State of Michigan. Individ uals included in this article were reported from 1987 to 1995. Cases were r eported by hospitals, physicians, the state workers' compensation bureau, o r from death certificates. Only individuals who met the criteria for silico sis developed by the National Institute for Occupational Safety and Health (NIOSH) were included. Results: Medical records were reviewed of 583 indivi duals with confirmed silicosis, This was mainly a population of elderly men . Ten percent of the 583 silicotics were found to have some mention of chro nic kidney disease, and 33% of the 283 silicotics who we had laboratory tes ts on had a serum creatinine level >1.5 mg/dl. An association between kidne y disease and age and between kidney disease and race was found among this cohort of 583 silicotics. Individuals with silicosis were more likely to ha ve a serum creatinine level >1.5 mg/dl than age- and race-matched controls. However, no relationship between duration of exposure to silica or profusi on of scarring on chest X-ray and prevalence of kidney disease or elevated creatinine levels was found. Conclusions: This study confirms previous case reports and epidemiologic studies of end-stage renal disease that found an association between kidney disease and exposure to silica, The epidemiolog ic data are conflicting on the mechanism by which silica causes kidney dise ase and are compatible with silica being able to cause kidney disease by bo th an autoimmune and direct nephrotoxic effect. Chronic kidney disease shou ld be considered as a complication of silicosis, Copyright (C) 2000 S. Karg er AG, Basel.