Long-term observation of serum creatinine and arterial blood pH in persons with cadmium-induced renal dysfunction.
Twenty-one subjects who had cadmium (Cd)-induced renal dysfunction and who lived in a Cd-polluted area in Japan were investigated to determine changes in their renal function. Since 1974, serum creatinine and arterial blood pH were measured annually during the autumn months for 9-14 y. Mean serum creatinine was significantly increased during this period, i.e., from 1.19 +/- 1.28 mg/100 ml to 1.68 +/- 1.56 mg/100 ml. Even after cadmium exposure ceased, significant deterioration of glomerular filtration was found. Eleven subjects showed a greater than 20% serum creatinine increase during this period. The most severe case had a serum creatinine value of 4.4 mg/100 ml at the most recent examination and experienced generalized edema, which suggests a clinical diagnosis of renal failure. The mean arterial blood pH values decreased significantly in all subjects, i.e., from 7.400 +/- 0.023 to 7.361 +/- 0.034. The 11 subjects cited above also showed a significant decrease and progression of tubular dysfunction after Cd exposure ceased. Our findings suggest that Cd-induced renal tubular dysfunction and decreased glomerular filtration are aggravated even after cessation of environmental Cd exposure, and in some cases this renal dysfunction may progress to renal failure.
Kido
T
T
Department of Hygiene and Public Health, Kanazawa Medical University, Ishikawa, Japan.
Nogawa
K
K
Ishizaki
M
M
Honda
R
R
Tsuritani
I
I
Yamada
Y
Y
Nakagawa
H
H
Nishi
M
M
D058186:Acute Kidney Injury / Q000097:blood* / Q000139:chemically induced; D000368:Aged; D002104:Cadmium / Q000009:adverse effects* / Q000032:analysis / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood*; D004787:Environmental Pollution / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005506:Food Contamination / Q000032:analysis; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007684:Kidney Tubules / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012275:Oryza / Q000032:analysis
D002104:Cadmium; D003404:Creatinine