title: Cadmium or cadmium compounds and chronic kidney disease in workers and the general population: a systematic review.
abstract: BACKGROUND
  Cadmium (Cd) is abundantly documented as a metal mainly affecting tubular function both in workers and in the general population indirectly exposed via the environment. Results from epidemiological studies linking Cd exposure and risk of progression to chronic kidney disease (CKD) are, however, conflicting.
  
  
  OBJECTIVE
  To perform a systematic review of the association between Cd exposure and CKD.
  
  
  METHODS
  A systematic appraisal of publications found in MEDLINE (1946-2014), EMBASE (1974-2012) and an in-house database (1986-2013) was conducted. Additional studies were searched for by contacting experts and checking reference lists. Search terms used key and text words. No language restriction was applied. Cohort, case-control and case-series with follow-up including individual and objective assessment of occupational or environmental exposure were eligible. Studies were selected and data extracted by two independent reviewers using predefined forms. Study characteristics and results were extracted to structured tables. Synthesis was qualitative and results appraised with causality criteria.
  
  
  RESULTS
  Thirty-four exposed groups, totaling more than 3000 participants, were eligible. Overall, results disclosed no convincing evidence supporting a risk of progression to CKD in populations exposed to Cd. Lack of information about methods, risk of bias and heterogeneity were identified as limitations and precluded conducting a meta-analysis. Publication bias did not appear as a major problem.
  
  
  CONCLUSIONS
  This qualitative systematic review does not support the contention that human exposure to Cd leads to progressive CKD.
authors.affiliation: a Division of Occupational and Environmental Medicine , University of Zurich and University Hospital Zurich , Zurich , Switzerland .
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Byber
authors.affiliation: b Louvain Centre for Toxicology and Applied Pharmacology, IREC, Université Catholique de Louvain , Brussels , Belgium , and.
authors.forename: Dominique
authors.initials: D
authors.lastname: Lison
authors.affiliation: b Louvain Centre for Toxicology and Applied Pharmacology, IREC, Université Catholique de Louvain , Brussels , Belgium , and.|c Eurometaux , Brussels , Belgium.
authors.forename: Violaine
authors.initials: V
authors.lastname: Verougstraete
authors.affiliation: a Division of Occupational and Environmental Medicine , University of Zurich and University Hospital Zurich , Zurich , Switzerland .
authors.forename: Holger
authors.initials: H
authors.lastname: Dressel
authors.affiliation: a Division of Occupational and Environmental Medicine , University of Zurich and University Hospital Zurich , Zurich , Switzerland .|b Louvain Centre for Toxicology and Applied Pharmacology, IREC, Université Catholique de Louvain , Brussels , Belgium , and.
authors.forename: Philipp
authors.initials: P
authors.lastname: Hotz
mesh_terms: D002104:Cadmium / Q000633:toxicity*; D019187:Cadmium Compounds / Q000633:toxicity*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D015201:Meta-Analysis as Topic; D016273:Occupational Exposure / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000139:chemically induced; D012307:Risk Factors
chemical_list: D019187:Cadmium Compounds; D002104:Cadmium
keywords: Albuminuria; cohort; environmental exposure; follow-up; glomerular filtration rate; kidney failure; occupational disease; proteinuria