Common levels of lead contamination in U.S. drinking water might have adverse health effects for patients with chronic kidney disease, according to a new study.

"Our findings suggested that lead contamination had detectable, clinically relevant adverse effects in at-risk individuals, even at levels below the current Environmental Protection Agency actionable threshold for U.S. households," said study author, John Danziger, M.D.

The cross-sectional study, published in JAMA Internal Medicine, was conducted by researchers from Beth Israel Deaconess Medical Center and Fresenius Medical Care. It analyzed data from 6,404 patients with kidney failure who began dialysis at a Fresenius Medical Care outpatient facility between January 1, 2017- December 20, 2021. The study examined the association between lead concentrations in household water and hematologic toxic effects.

The findings revealed 12% of patients had measurable lead in household drinking water. Higher levels of household lead were associated with a 15% higher risk of requiring maximum monthly erythropoiesis-stimulating agent dosing, a medication used to treat anemia in chronic kidney disease (CKD) patients. Additionally, patients with higher household lead levels had lower hemoglobin concentrations, particularly among those with concurrent iron deficiency.

The study suggested that even low levels of lead exposure, as commonly found in U.S. drinking water, might have detectable and clinically relevant adverse effects on susceptible individuals, such as those with advanced CKD. The authors noted findings underscore the need for more rigorous assessment of household water quality and its association with health outcomes in at-risk populations.

Some of the study authors were employees of Fresenius Medical Care, a dialysis service provider.