Low level exposure to cadmium increases the risk of chronic kidney disease: analysis of the NHANES 1999-2006.
BACKGROUND
Environmental factors have been associated with the outbreak of chronic kidney disease (CKD). We evaluated the association of Cadmium (Cd) exposure with the risk of CKD in U.S. adults who participated in the 1999-2006 National Health and Nutrition Examination Surveys (NHANES).


METHODS
5426 subjects > or = 20 years were stratified for values of urinary and blood Cd and a multivariate logistic regression was performed to test the association between blood and urinary Cd, CKD and albuminuria (ALB) after adjustment for age, gender, race/ethnicity, body mass index and smoking habits.


RESULTS
Subjects with urinary Cd > 1 mcg/g and subjects with blood Cd > 1 mcg/L showed a higher association with ALB (OR 1.63, 95% CI 1.23, 2.16; P = 0.001). Subjects with blood Cd > 1 mcg/L showed a higher association with both CKD (OR 1.48, 95% CI 1.01, 2.17; P = 0.046) and ALB (OR 1.41, 95% CI 1.10, 1.82; P = 0.007). An interaction effect on ALB was found for high levels of urinary and blood Cd (P = 0.014).


CONCLUSIONS
Moderately high levels of urinary and blood Cd are associated with a higher proportion of CKD and ALB in the United States population.
Division of Nephrology and Dialysis, Columbus-Gemelli University Hospital, Renal Program, Catholic University, Rome, Italy.
Pietro Manuel
PM
Ferraro
Stefano
S
Costanzi
Alessandro
A
Naticchia
Antonio
A
Sturniolo
Giovanni
G
Gambaro
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium / Q000097:blood* / Q000633:toxicity / Q000652:urine*; D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D016017:Odds Ratio; D012306:Risk; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D002104:Cadmium