LETTER
Over-the-Counter Chromium and Renal Failure
H. Jakob Michenfelder, MD;
Jennifer Thompson, MD; and
Mark Shepherd, MD
15 October 1997 | Volume 127 Issue 8 (Part 1) | Page 655
TO THE EDITOR:
In a recent letter, Wasser and colleagues [1] state that intake of chromium picolinate can lead to chronic interstitial nephritis. They cite the case of a woman with unexpected chronic renal failure, biopsy-proven chronic interstitial nephritis, and documented normal renal function 2 years earlier who had taken 600 µg of chromium picolinate for 6 weeks 5 months before the diagnosis of chronic renal failure.
We strongly disagree with the authors' conclusion. Chronic interstitial nephritis can have many causes [2]; the temporal relation of the discovery of the chronic renal failure and the intake of chromium picolinate does not prove a causal relation. One of the cited references [3], by using controversial data and hypotheses [4], predicts that 600 µg of chromium picolinate taken daily for 5 years could result in tissue accumulation of chromium levels that may be cytotoxic and genotoxic. Even if this controversial model is correct, it does not provide sufficient grounds to postulate that 600 µg of chromium picolinate taken daily for 6 weeks could result in nephrotoxicity.
We are investigating the effect of 500 µg of chromium picolinate taken daily for 3 months on glucose metabolism and insulin sensitivity in diabetic patients and normal volunteers. Of the 11 participants who have completed the study so far, none has shown any change in renal function. In addition, chromium picolinate has been used in doses of 1000 µg daily for 4 months in 60 diabetic patients, with no reported side effects [5].
In summary, we do not think that the available information allows the conclusion that chromium picolinate is nephrotoxic.
Mark Shepherd, MD
Tupelo, MS 38801
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Author and Article Information
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David Grant United States Air Force Medical Center; Travis AFB, CA 94535-1800
Tupelo, MS 38801
1. Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate [Letter]. Ann Intern Med. 1997; 126:410.
2. Eknoyan G. Chronic tubulointerstitial nephropathies. In: Schrier RW, Gottschal CW, eds. Diseases of the Kidney. Boston: Little, Brown; 1997; 1938-2015.
3. Stearns DM, Belbruno DJ, Wetterhahn KE. A prediction of chromium (III) accumulation in humans from chromium dietary supplements. FASEB J. 1995; 9:1650-7.
4. McCarty MF. Chromium (III) picolinate. FASEB J. 1996; 10:365-9.
5. Anderson R, Cheng N, Bryden N, Polansky M, Cheng N, Chi J, et al. Beneficial effects of chromium for people with type II diabetes mellitus [Abstract]. Diabetes. 1996; 45:124A.
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