title: Cadmium-induced renal dysfunction and mortality in two cohorts: disappearance of the association in a generation born later.
abstract: The association between exposure to environmental cadmium and mortality was investigated in two cohorts. The study population consisted of 275 (cohort I) and 329 (cohort II) residents (aged >or=40 years) in a cadmium-polluted area, Nagasaki Prefecture, Japan, who had participated in health surveys conducted in 1982 and 1992, respectively. The follow-up period extended from 1982 or 1992 to 2005. In the study area, the dietary cadmium intake had decreased after 1980-1983 because of the restoration of cadmium-polluted paddy fields. In cohort I, the mortality rate among those with urinary beta2-microglobulin (beta2-MG) concentration >or=1000 microg/g creatinine (cr.) was 1.41 times higher than the regional reference rate (95% confidence interval [CI] 1.07-1.83). After adjusting for age and other variables, in men, urinary N-acetyl-beta-D-glucosaminidase, and in women, serum creatinine, beta2-MG clearance, and urinary beta2-MG were significantly associated with increased mortality. However, in cohort II, urinary beta2-MG or total protein was not significantly associated with survival. These findings indicate that cadmium-induced renal dysfunction was a significant predictor of mortality, but that such an association is disappearing, probably because of the selective loss of advanced cases and reduced exposure and body burden.
authors.affiliation: Department of Preventive Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15, Tokushima 770-8503, Japan. arisawa@basic.med.tokushima-u.ac.jp
authors.forename: Kokichi
authors.initials: K
authors.lastname: Arisawa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Uemura
authors.forename: Mineyoshi
authors.initials: M
authors.lastname: Hiyoshi
authors.forename: Hideo
authors.initials: H
authors.lastname: Takeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
authors.forename: Midori
authors.initials: M
authors.lastname: Soda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium / Q000633:toxicity* / Q000652:urine; D015331:Cohort Studies; D004784:Environmental Monitoring / Q000379:methods*; D004785:Environmental Pollutants / Q000633:toxicity* / Q000652:urine; D062665:Epidemiological Monitoring; D005260:Female; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000401:mortality* / Q000652:urine; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D013997:Time Factors
chemical_list: D004785:Environmental Pollutants; D002104:Cadmium