國家衛生研究院 NHRI:Item 3990099045/13456
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/13456


    Title: Melamine exposure threshold in early chronic kidney disease patients - A benchmark dose approach
    Authors: Chen, CC;Tsai, YC;Wang, YH;Wu, CF;Chiu, YW;Hwang, SJ;Liu, CC;Hsieh, TJ;Wu, MT
    Contributors: Institute of Population Health Sciences
    Abstract: Environmental melamine exposure has been associated with deteriorating kidney function in early-stage chronic kidney disease patients. In this study, a benchmark dose (BMD) approach was used to establish melamine exposure threshold in 293 patients with eGFR≥30 ml/min per 1.73 m(2). The patients were enrolled 2006-2010 and followed-up for a median of 7.0 years to monitor kidney outcomes. Average daily intakes (AvDI) of melamine were estimated using one-spot urine samples collected at enrollment. BMDs and corresponding one-sided 95% lower bound (BMDLs) were derived using established dose-response models relating estimated AvDIs and dichotomous kidney outcomes: doubling of serum creatine levels, eGFR decreased > 3 ml/min per 1.73 m(2) per year, and >30% decline in eGFR during the first 2 years. In addition, survival time to doubling of serum creatinine and eGFR decline over time were assessed as continuous endpoints. Given a benchmark response of 0.10, BMDLs ranged from 0.74 to 2.03 μg/kg_bw/day after Bayesian model averaging, a range one to two orders lower than the current WHO recommended tolerable daily intake of 200 μg/kg_bw/day and the US FDA's 63 μg/kg_bw/day. Our results suggest that early-stage CKD patients should strictly refrain from using melamine tableware and related melamine-made products.
    Date: 2021-11
    Relation: Environment International. 2021 Nov;156:Article number 106652.
    Link to: http://dx.doi.org/10.1016/j.envint.2021.106652
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0160-4120&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000685539700009
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85107824446
    Appears in Collections:[Chu-Chih Chen] Periodical Articles

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