Associations of serum lithium, nickel, cobalt, and manganese with chronic kidney disease among Chinese older adults: Mediating role of lipid metabolism and moderating effect of lifestyle.

Serum lithium, nickel, cobalt, and manganese are linked to a 56.3% greater risk of chronic kidney disease in Chinese older adults, with lithium contributing most strongly.

• Why it matters: Understanding how environmental metal exposure affects kidney health is crucial, especially in aging populations where CKD prevalence is rising. Identifying mediating factors like lipid metabolism can inform prevention strategies.
• What they did: The study measured serum metal levels in 844 older adults using ICP-MS and applied various statistical models, including WQS and BKMR, to analyze single and combined metal effects, alongside network toxicology and mediation analyses.
• The result: Higher serum levels of these metals and their mixture increased CKD risk, partly through triglyceride elevation, which healthy lifestyle behaviors can mitigate, highlighting potential intervention points.