Cross-sectional assessment of renal function in the inhabitants of a cadmium-polluted area.
To understand the development of cadmium (Cd)-induced renal tubular dysfunction, cross-sectional assessment of renal function in the inhabitants of the Cd-polluted Jinzu River basin in Toyama, Japan, was carried out. Sixty-seven men and 78 women, aged 56 to 71 years whose urinary beta 2-microglobulin (beta 2-m) exceeded 1,000 micrograms/g creatinine, were examined and divided into five groups according to their values of fractional excretion of beta 2-m (FE beta 2-m). Comparisons were made between six groups including the inhabitants of a non-polluted area as a reference group. Significantly increased values of fractional excretion of urate (FEUA), calcium (FECa), sodium (FENa), and chloride (FECl), serum creatinine and beta 2-m, and urinary protein were detected even in the subjects with FE beta 2-m level below 1 percent compared with the reference group. Fractional phosphate reabsorption (percent TRP) was significantly decreased in the subjects with FE beta 2-m level above 10 percent. Creatinine clearance (CCr) decreased with increase in FE beta 2-m, and the subjects with FE beta 2-m above 30 percent showed significantly decreased CCr values compared to those with FE beta 2-m below 30 percent. In summary, FEUA, FECa, FENa, and FECl, as well as low-molecular-weight proteins such as beta 2-m, are increased in the early stage of Cd-induced renal tubular dysfunction. Although percent TRP was maintained by the decreased CCr, there was a marked decrease in percent TRP in subjects with progressive stage showing FE beta 2-m level above 10 percent. No sex difference in renal tubular dysfunction was found in this cross-sectional study.
Aoshima
K
K
Toyama Medical and Pharmaceutical University, Japan.
Kawanishi
Y
Y
Fan
J J
JJ
Cai
Y Q
YQ
Katoh
T
T
Teranishi
H
H
Kasuya
M
M
D000368:Aged; D002105:Cadmium Poisoning / Q000503:physiopathology*; D002118:Calcium / Q000652:urine; D002712:Chlorides / Q000652:urine; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007564:Japan; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000652:urine; D012964:Sodium / Q000652:urine; D014527:Uric Acid / Q000652:urine; D014874:Water Pollutants, Chemical / Q000506:poisoning*; D001613:beta 2-Microglobulin / Q000378:metabolism / Q000652:urine
D002712:Chlorides; D014874:Water Pollutants, Chemical; D001613:beta 2-Microglobulin; D014527:Uric Acid; D012964:Sodium; D003404:Creatinine; D002118:Calcium