A 50-year follow-up of childhood plumbism. Hypertension, renal function, and hemoglobin levels among survivors.

A group of 192 subjects with well-documented lead poisoning in 1930 to 1942 were identified in this pilot study. Thirty-five of 72 survivors traced to a Boston area address and 22 age-, sex-, race-, and neighborhood-matched controls were recruited into a clinical study. One matched subject with plumbism had grossly abnormal renal function and an elevated blood lead level of an unclear cause. Among the remaining 21 matched pairs, the risk of hypertension was significantly higher in subjects with plumbism (relative risk, 7.0; 95% confidence interval, 1.2 to 42.3). Mean adjusted creatinine clearance rates for subjects with plumbism, however, were significantly higher than those of controls and supranormal in comparison to rates predicted for sex and age. Subjects with plumbism had significantly lower hemoglobin concentrations and hematocrit readings than the controls. Blood lead and serum creatinine levels were low for both groups. These results suggest that survivors of childhood lead poisoning have an increased risk of clinically significant hypertension developing in the setting of supranormal creatinine clearance rates.