title: Blood cadmium and estimated glomerular filtration rate in Korean adults.
abstract: BACKGROUND
  Cadmium is a nephrotoxicant at high exposure levels. Few studies have evaluated the role of cadmium in kidney function at low-exposure levels.
  
  
  OBJECTIVE
  We evaluated the association of blood cadmium with estimated glomerular filtration rate (eGFR) in the Korean adult population.
  
  
  METHODS
  We evaluated 1,909 adults ≥ 20 years of age who participated in the 2005 Korean National Health and Nutrition Examination Survey and had blood cadmium determinations. eGFR was calculated using the Modification of Diet in Renal Disease equation.
  
  
  RESULTS
  Blood cadmium geometric means were 1.57 μg/L for men and 1.49 μg/L for women. The difference in eGFR levels that compared participants in the highest versus lowest cadmium tertiles, after multivariable adjustment, was -1.85 [95% confidence interval (CI): -3.55, -0.16] mL/min per 1.73 m2 in women and 0.67 (-1.16, 2.50) mL/min per 1.73 m2 in men. Among men, the association between blood cadmium and eGFR was modified by blood lead levels (p-value for interaction = 0.048). The fully adjusted differences in eGFR levels for a 2-fold increase in blood cadmium levels were -1.14 (-3.35, 1.07) and 1.84 (0.54, 3.14) mL/min per 1.73 m2 in men with blood lead levels below and above the median (2.75 μg/dL), respectively.
  
  
  CONCLUSIONS
  Elevated blood cadmium levels were associated with lower eGFR in women, which supports the role of cadmium as a risk factor for chronic kidney disease. In men, there was no overall association, although elevated blood cadmium levels were associated with higher eGFR levels in men with high blood lead levels and nonstatistically associated with lower eGFR levels in men with low blood lead levels.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
authors.forename: Young
authors.initials: Y
authors.lastname: Hwangbo
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Weaver
authors.forename: Maria
authors.initials: M
authors.lastname: Tellez-Plaza
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: Byung-Kook
authors.initials: BK
authors.lastname: Lee
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
mesh_terms: D000328:Adult; D000368:Aged; D002104:Cadmium / Q000097:blood* / Q000633:toxicity; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D056910:Republic of Korea; D012307:Risk Factors
chemical_list: D002104:Cadmium