title: Urinary and blood cadmium and lead and kidney function: NHANES 2007-2012.
abstract: BACKGROUND
  Cadmium (Cd) and lead (Pb) are widespread environmental contaminants that are known nephrotoxins. However, their nephrotoxic effects at low-environmental exposure levels are debated.
  
  
  OBJECTIVE
  We examined the association of blood Pb (B-Pb), blood Cd (B-Cd), urinary Pb (U-Pb) and urinary Cd (U-Cd) with estimated glomerular filtration rate (eGFR) and urinary albumin (ALB).
  
  
  METHODS
  We used multivariate linear regression to analyze the association between B-Pb, B-Cd, U-Pb, and U-Cd with eGFR and ALB in adult participants (≥20 years of age) in NHANES 2007-2012. The dataset was limited to NHANES individuals with both blood and urinary metal measurements.
  
  
  RESULTS
  We found a statistically significant inverse association between eGFR and B-Cd and statistically significant positive associations between eGFR and both U-Cd and U-Pb, as well as statistically significant associations between ALB and the 3rd and 4th quartiles of U-Cd.
  
  
  CONCLUSIONS
  The inverse association between eGFR and B-Cd, in conjunction with positive associations between eGFR and ALB with U-Cd, suggest that U-Cd measurement at low levels of exposure may result from changes in renal excretion of Cd due to kidney function and protein excretion. However, renal effects such as hyperfiltration from Cd-mediated kidney damage or creatinine-specific Cd effects cannot be excluded with this cross-sectional design.
authors: Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA.
authors: Melanie C
authors: MC
authors: Buser
authors: Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA.
authors: Susan Z
authors: SZ
authors: Ingber
authors: Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA.
authors: Nathan
authors: N
authors: Raines
authors: Division of Community Health Investigations, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA.
authors: David A
authors: DA
authors: Fowler
authors: Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA. Electronic address: fes6@cdc.gov.
authors: Franco
authors: F
authors: Scinicariello
mesh_terms: D000328:Adult; D000419:Albuminuria; D002104:Cadmium / Q000097:blood / Q000652:urine; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000097:blood / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007854:Lead / Q000097:blood / Q000652:urine; D008297:Male; D009749:Nutrition Surveys; D014481:United States
chemical_list: D004785:Environmental Pollutants; D002104:Cadmium; D007854:Lead
keywords: Albuminuria; Blood cadmium; Blood lead; Estimated glomerular filtration rate; Urinary cadmium; Urinary lead