title: Blood cadmium and lead and chronic kidney disease in US adults: a joint analysis.
abstract: Environmental cadmium and lead exposures are widespread, and both metals are nephrotoxic at high exposure levels. Few studies have evaluated the associations between low-level cadmium and clinical renal outcomes, particularly with respect to joint cadmium and lead exposure. The geometric mean levels of blood cadmium and lead were 0.41 microg/L (3.65 nmol/L) and 1.58 microg/dL (0.076 micromol/L), respectively, in 14,778 adults aged >or=20 years who participated in the National Health and Nutrition Examination Survey (1999-2006). After adjustment for survey year, sociodemographic factors, chronic kidney disease risk factors, and blood lead, the odds ratios for albuminuria (>or=30 mg/g creatinine), reduced estimated glomerular filtration rate (eGFR) (<60 mL/minute/1.73 m(2)), and both albuminuria and reduced eGFR were 1.92 (95% confidence interval (CI): 1.53, 2.43), 1.32 (95% CI: 1.04, 1.68), and 2.91 (95% CI: 1.76, 4.81), respectively, comparing the highest with the lowest blood cadmium quartiles. The odds ratios comparing participants in the highest with the lowest quartiles of both cadmium and lead were 2.34 (95% CI: 1.72, 3.18) for albuminuria, 1.98 (95% CI: 1.27, 3.10) for reduced eGFR, and 4.10 (95% CI: 1.58, 10.65) for both outcomes. These findings support consideration of cadmium and lead as chronic kidney disease risk factors in the general population and provide novel evidence of risk with environmental exposure to both metals.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
authors.forename: Maria
authors.initials: M
authors.lastname: Tellez-Plaza
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Ellen
authors.initials: E
authors.lastname: Silbergeld
authors.forename: Bernard
authors.initials: B
authors.lastname: Jaar
authors.forename: Virginia
authors.initials: V
authors.lastname: Weaver
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology; D002104:Cadmium / Q000097:blood* / Q000633:toxicity; D002908:Chronic Disease; D004781:Environmental Exposure / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000633:toxicity*; D005919:Glomerular Filtration Rate; D015438:Health Behavior; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000139:chemically induced / Q000453:epidemiology; D007854:Lead / Q000097:blood* / Q000633:toxicity; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D002104:Cadmium; D007854:Lead
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