Abstract
Environmental exposure to moderate-to-high levels of cadmium (Cd) and lead (Pb) is associated with nephrotoxicity. In comparison, the health impacts of chronic low-level exposure to Cd and Pb remain controversial. The aim of this study was to therefore evaluate kidney dysfunction associated with chronic low-level exposure to Cd and Pb in a population of residents in Bangkok, Thailand. The mean age and the estimated glomerular filtration rate (eGFR) for 392 participants (195 men and 197 women) were 34.9 years and 104 mL/min/1.73 m2, respectively, while the geometric mean concentrations of urinary Cd and Pb were 0.25 μg/L (0.45 μg/g of creatinine) and 0.89 μg/L (1.52 μg/g of creatinine), respectively. In a multivariable regression analysis, the eGFR varied inversely with blood urea nitrogen in both men (β = −0.125, p = 0.044) and women (β = −0.170, p = 0.008), while inverse associations of the eGFR with urinary Cd (β = −0.132, p = 0.043) and urinary Pb (β = −0.130, p = 0.044) were seen only in women. An increased urinary level of Cd to the median level of 0.38 μg/L (0.44 μg/g of creatinine) was associated with a decrease in the eGFR by 4.94 mL/min/1.73 m2 (p = 0.011). The prevalence odds of a reduced eGFR rose 2.5-, 2.9- and 2.3-fold in the urinary Cd quartile 3 (p = 0.013), the urinary Cd quartile 4 (p = 0.008), and the urinary Pb quartile 4 (p = 0.039), respectively. This study suggests that chronic exposure to low-level Cd is associated with a decline in kidney function and that women may be more susceptible than men to nephrotoxicity due to an elevated intake of Cd and Pb.
Highlights
Cadmium (Cd) and lead (Pb) are environmental toxicants of significant public health concern due to their widespread environmental pollution and persistence, as well as their known adverse impacts on human health, including an enhanced risk of chronic kidney disease (CKD) and various types of cancer [1,2,3,4,5]
This study suggests that chronic exposure to low-level Cd is associated with a decline in kidney function and that women may be more susceptible than men to nephrotoxicity due to an elevated intake of Cd and Pb
The percentage of the estimated glomerular filtration rate (eGFR)
Summary
Cadmium (Cd) and lead (Pb) are environmental toxicants of significant public health concern due to their widespread environmental pollution and persistence, as well as their known adverse impacts on human health, including an enhanced risk of chronic kidney disease (CKD) and various types of cancer [1,2,3,4,5]. The International Agency for Research on Cancer has established Cd as a human carcinogen [6], while the carcinogenicity of chronic Pb exposure in workplace settings has been observed in two large prospective cohort studies [7,8]. Co-exposure to low levels of environmental Cd and Pb has been reported in large population-based studies in the U.S [9,10,11,12], Canada [13], Taiwan [14], Toxics 2020, 8, 18; doi:10.3390/toxics8010018 www.mdpi.com/journal/toxics. Its high worldwide prevalence and escalating treatment costs make developing strategies to prevent CKD of global importance [16,17,18]
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