Relationship Between Milk Adulterated With Melamine and the Appearance of Renal Stones in a Childhood Population: A Review of the Literature of the Cases That Occurred in the People’s Republic of China
DOI:
https://doi.org/10.14306/renhyd.16.2.95Keywords:
Milk substitutes, Melamine, Food adulteration, Nephrolithiasis, Kidney calculi, Infant, EpidemiologyAbstract
Introduction: Melamine is a chemical substance used in the production of resins. When melamine is added to milk, nitrogen concentration increases, which suggest an increase the amount of false proteins and consequently causing kidney diseases in some population subgroups. The objective of this study is to document the possible connection in between adulterated industrial milk with melamine and the appearance of kidney stones in children under 12 years old by reviewing cases occurred in the People’s Republic of China.
Material and methods: A literature review was carried out on articles published on dated between 2005-2010, and an extensive analysis was made on the results found.
Results: A total of 20 articles were reviewed, of which 11 met the criteria for inclusion, There were 9 cross-sectional studies, one follow-up study and a case-control study. Four studies calculated odds ratio (OR) in their analysis to evaluate the relative risk of having stones in those children exposed to melamine formula. In the case-control study, children exposed to melamine formula were 5.17 times as likely to have kidney stones as children exposed to a non-melamine formula (95% confidence interval, 3.28-8.14; P<.001).
Conclusions: Melamine adulteration in milk is a preventable public health issue which suggests the establishing of greater control measures and the implementation of food regulations by the food industry and Health and Food Institutions.
References
Fink JK. Melamine resins. En: Fink JK. Reactive polymers fundamentals and applications: a concise guide to industrial polymers. New York: William Andrew Publishing; 2005. p. 299-305.
Lam HS, Ng PC, Chu WC, Wong W, Chan DF, Ho SS, et al. Renal screening in children after exposure to low dose melamine in Hong Kong: cross sectional study. BMJ. 2008;337:a2991.
Suchý P, Straková E, Herzig I, Stana J, Kalusová R, Pospíchalová M. Toxicological risk of melamine and cyanuric acid in food and feed. Interdiscip Toxicol. 2009;2:55-9.
Ortiz Moncada MR, Serra Majem L. Políticas de nutrición. En: Serra-Majem L, Aranceta J, editores. Nutrición y salud pública: métodos, bases científicas y aplicaciones. 2.a ed. Barcelona: Masson; 2006. p. 666-75.
Álvarez-Dardet Díaz C, Ortiz Moncada MR, Serra Majem L, Mata Albert E. Peligros y riesgos sanitarios asociados a los alimentos. En: Sierra Lopez A, Saenz González MC, Fernández-Crehuet Navajas J, et al, editores. Piedrola Gil. Medicina preventiva y salud pública. 11.a ed. Barcelona: Elsevier-Masson; 2008. p. 401-22.
Serra Majem L, Ribas Barba L, Ortiz Moncada MR. Políticas de nutrición y salud pública: ¿más ciencia o más política? En: Alemany M, Bernabeu-Mestre J. Bioética y nutrición. Salamanca: Universidad de Alicante, Editorial Agua Clara; 2010. p. 123-48.
Mercado C. Los ámbitos normativos, la gestión de la calidad y la inocuidad alimentaria: una visión integral. Agroalimentaria. 2007;24:119-31.
Zhu SL, Li JH, Chen L, Bao ZX, Zhang LJ, Li JP, et al. Conservative management of pediatric nephrolithiasis caused by melamine-contaminated milk powder. Pediatrics. 2009;123: e1099-102.
Hu SL, Wu L, Chen Y, Pan JH, Xu WP, Wang L, et al. Investigation on the incidence of urolithiasis in infants fed by milk power tainted with melamine in the middle area of Anhui Province. Chin J Evid-based Med. 2008;8:1039-42.
Zhang L, Wu LL, Wang YP, Liu AM, Zou CC, Zhao ZY. Melamine-contaminated milk products induced urinary tract calculi in children. World J Pediatr. 2009;5:31-5.
Guan N, Fan Q, Ding J, Zhao Y, Lu J, Ai Y, et al. Melamine-contaminated powdered formula and urolithiasis in young children. N Engl J Med. 2009;360:1067-74.
Yang H, Wang Q, Luo J, Li Q, Wang L, Li CC, et al. Ultrasound of urinary system and urinary screening in 14 256 asymptomatic children in China. Nephrology (Carlton). 2010;15:362-7.
Jia LQ, Shen Y, Wang XM, He LJ, Xin Y, Hu YX. Ultrasonographic diagnosis of urinary calculus caused by melamine in children. Chin Med J (Engl). 2009;122:252-6.
Wen JG, Li ZZ, Zhang H, Wang Y, Zhang RF, Yang L, et al. Melamine related bilateral renal calculi in 50 children: single center experience in clinical diagnosis and treatment. J Urol. 2010;183:1533-7.
He Y, Jiang GP, Zhao L, Qian JJ, Yang XZ, Li XY, et al. Ultrasonographic characteristics of urolithiasis in children exposed to melamine-tainted powdered formula. World J Pediatr. 2009;5:118-21.
Sun Q, Shen Y, Sun N, Zhang GJ, Chen Z, Fan JF, et al. Diagnosis, treatment and follow-up of 25 patients with melamine-induced kidney stones complicated by acute obstructive renal failure in Beijing Children’s Hospital. Eur J Pediatr. 2010;169:483-9.
Chang YM, Tong XM, Wang XL, Zhao YM. [Follow-up study on children with urinary calculi associated with exposure to melamine-contaminated formula]. Zhongguo Dang Dai Er Ke Za Zhi. 2010;12:278-9.
Wei Y, Liu D. Review of melamine scandal: still a long way ahead. Toxicol Ind Health. 2011 Oct 10 [Epub ahead of print].
Palau A. Continuidad y cambio en las políticas públicas: el caso de la política de seguridad alimentaria en España (1981-2001). Rev Esp Ciencia Política. 2009;21:47-68.
Almansa A, Borda IA, Abaitua MA, Banegas JR. Effects of toxic oil syndrome on the psychological conditions of the descendants of affected persons. Epidemiol Prev. 2008;32:212-7.
Izquierdo J. La justicia del accidente, variaciones sobre el síndrome del síndrome del aceite tóxico español. Rev Antropol Soc. 2003;12:287-320.
Gelpí E, De la Paz MP, Terracini B, Abaitua I, De la Cámara AG, Kilbourne EM, et al; WHO/CISAT Scientific Committee for the Toxic Oil Syndrome. Centro de Investigación para el Síndrome del Aceite Tóxico. The Spanish toxic oil syndrome 20 years after its onset: a multidisciplinary review of scientific knowledge. Environ Health Perspect. 2002;110:457-64.
Codexalimentarius.net [portal en internet]. Roma: Normas alimentarias FAO/OMS Online [actualizado 2011; citado 22 Jun 2011]. Disponible en: http://www.codexalimentarius.net/web/index_es.jsp
Spreij M, Vapnek J. Directrices en materia de legislación alimentaria: nuevo modelo de ley de alimentos para países de tradición jurídica romano-germánica. Roma: Organización de las Naciones Unidas para la Agricultura y la Alimentación; 2006.
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