Relationship between occupational lead exposure and the risk of kidney damage: a literature review

Abstract

Methods: A bibliographic review was conducted in PubMed, SciELO, Web of Science, and the Virtual Health Library (VHL), including open-access articles in English and Spanish, human studies, published between 2015 and 2025. The search strategy combined DeCS/MeSH terms: “Lead” OR “Lead poisoning” OR “Lead intoxication” AND “Kidney diseases” OR “Renal insufficiency” OR “Nephrosis” AND “Occupational risks” OR “Occupational exposure.” A PRISMA diagram was documented, with identified records (n = 267), screening, eligibility assessment (n = 72), and final inclusion (n = 32), after excluding duplicates and ambiguous or non-relevant articles. Results: Occupations with the highest likelihood of exposure include painters, battery mechanics, gasoline handlers, and net manufacturing workers, with evidence of exposure even at low–moderate levels. Lead exposure is associated with proximal tubular dysfunction and glomerular alterations; KIM-1 stands out as a sensitive biomarker of subclinical tubular injury, and Cystatin C supports the detection of changes in renal function (eGFR). Population studies show an association between lead levels and higher frequency of proteinuria, reduced eGFR, and greater likelihood of CKD, with interaction of factors such as age, smoking, and metabolic comorbidities. Conclusions: Occupational lead exposure remains a public and occupational health concern, with consistent links to early and established kidney damage, especially predominant tubular injury, detectable through biomarkers such as KIM-1 and Cystatin C. Persistent regulatory shortcomings in controlling lead in products and workplaces contribute to ongoing risk; therefore, early workplace screening programs, renal biomarker monitoring, and preventive measures to reduce exposure are recommended.