Environmental heavy metal exposure and chronic kidney disease in the general population.
Lead (Pb), mercury (Hg), and cadmium (Cd) are common heavy metal toxins and cause toxicological renal effects at high levels, but the relevance of low-level environmental exposures in the general population is controversial. A total of 1,797 adults who participated in the KNHANES (a cross-sectional nationally representative survey in Korea) were examined, and 128 of them (7.1%) had chronic kidney disease (CKD). Our study assessed the association between Pb, Hg, Cd exposure, and CKD. Blood Pb and Cd levels were correlated with CKD in univariate logistic regression model. However, these environmental heavy metals were not associated with CKD after adjustment for age, sex, BMI, smoking, hyperlipidemia, hypertension, diabetes, and these metals in multivariate logistic regression models. We stratified the analysis according to hypertension or diabetes. In the adults with hypertension or diabetes, CKD had a significant association with elevated blood Cd after adjustment, but no association was present with blood Pb and Hg. The corresponding odds ratio [OR] of Cd for CKD were 1.52 (95% confidence interval [CI], 1.05-2.19, P=0.026) in adults with hypertension and 1.92 (95% CI, 1.14-3.25, P=0.014) in adults with diabetes. Environmental low level of Pb, Hg, Cd exposure in the general population was not associated with CKD. However, Cd exposure was associated with CKD, especially in adults with hypertension or diabetes. This finding suggests that environmental low Cd exposure may be a contributor to the risk of CKD in adults with hypertension or diabetes.
Department of Nephrology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Nam Hee
0000-0002-2686-9754
NH
Kim
Department of Nephrology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Young Youl
YY
Hyun
Department of Nephrology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Kyu-Beck
0000-0002-3904-5404
KB
Lee
Department of Occupational Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Yoosoo
Y
Chang
Seungho
S
Ryu
Department of Occupational Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
Seungho
S
Rhu
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kook-Hwan
KH
Oh
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Curie
C
Ahn
D000328:Adult; D002104:Cadmium / Q000097:blood / Q000633:toxicity*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology; D004781:Environmental Exposure; D005260:Female; D000075322:Heavy Metal Poisoning; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000453:epidemiology; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D007854:Lead / Q000097:blood / Q000633:toxicity*; D008297:Male; D008628:Mercury / Q000097:blood / Q000633:toxicity*; D008875:Middle Aged; D009749:Nutrition Surveys; D011041:Poisoning / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D056910:Republic of Korea; D011795:Surveys and Questionnaires; D055815:Young Adult
D002104:Cadmium; D007854:Lead; D008628:Mercury
Cadmium; Environmental Low Exposure; Lead; Mercury; Renal Insufficiency