Renal Effects of Dental Amalgam in Children: The New England Children’s Amalgam Trial
- 1 March 2008
- journal article
- research article
- Published by Environmental Health Perspectives in Environmental Health Perspectives
- Vol. 116 (3), 394-399
- https://doi.org/10.1289/ehp.10504
Abstract
Mercury is nephrotoxic and dental amalgam is a source of mercury exposure. Children 6–10 years of age (n = 534) with two or more posterior teeth with caries but no prior amalgam restorations, were randomized to one of two treatments—amalgam or resin composite (white fillings)—used for caries treatment during 5 years of follow-up. The primary outcome was change in IQ, but important secondary outcomes were effects on markers of glomerular and tubular kidney function: urinary excretion of albumin, alpha-1-microglobulin (A1M), γ-glutamyl transpeptidase (γ-GT), and N-acetyl-β-d-glucosaminidase (NAG). These markers were measured on several occasions during the trial, together with urinary mercury and covariates. We evaluated the results using repeated-measures analyses. There were no significant differences between treatment groups in average levels of renal biomarkers, nor significant effects of number of dental amalgams on these markers. There was, however, a significantly increased prevalence of microalbuminuria (MA) among children in the amalgam group in years 3–5 (adjusted odds ratio 1.8; 95% confidence interval, 1.1–2.9). Most of these cases are likely to be temporary MA, but 10 children in the amalgam group had MA in both years 3 and 5, versus 2 children in the composite group (p = 0.04). There were no differences in the occurrence of high levels of renal tubular markers (A1M, γ-GT, or NAG). The increase in MA may be a random finding, but should be tested further. The results did not support recent findings in an observational study of an effect of low-level mercury on tubular biomarkers in children.Keywords
This publication has 43 references indexed in Scilit:
- Urinary mercury in people living near point sources of mercury emissionsScience of The Total Environment, 2006
- The Toxicology of Mercury and Its Chemical CompoundsCritical Reviews in Toxicology, 2006
- Urinary mercury concentrations associated with dental restorations in adult women aged 16-49 years: United States, 1999-2000Occupational and Environmental Medicine, 2005
- Immunology and genetics of induced systemic autoimmunityAutoimmunity Reviews, 2005
- Nephropathy in DiabetesDiabetes Care, 2004
- EXAMINATION OF DIETARY METHYLMERCURY EXPOSURE IN THE CASA PIA STUDY OF THE HEALTH EFFECTS OF DENTAL AMALGAMS IN CHILDRENJournal of Toxicology and Environmental Health, Part A, 2001
- Low level exposure to cadmium and early kidney damage: the OSCAR studyOccupational and Environmental Medicine, 2000
- Factors Affecting Internal Mercury Burdens among Eastern German ChildrenArchives of environmental health, 1997
- Does Amalgam Affect the Immune System? A Controversial Issue (Part 1 of 2)International Archives of Allergy and Immunology, 1995
- Membranous nephropathy caused by mercury-containing skin lightening creamPublished by Oxford University Press (OUP) ,1987