Abstract
BackgroundExcess cadmium (Cd) intake poses a general risk to health and to the kidneys in particular. Among indices of renal dysfunction under Cd burden measures are the urinary N-acetyl-β-D-glucosidase (UNAG) and urinary β2-microglobulin (Uβ2-MG) enzymes. However, the end-pointed values and the Cd burden threshold remain controversial because the scopes fluctuate widely.MethodsTo ascertain the clinical benchmark dose of urinary Cd (UCd) burden for renal dysfunction, 1595 residents near a Cd site were surveyed. Urine was sampled and assayed. A benchmark dose low (BMDL) was obtained by fitting UCd levels and index levels.ResultsWe found that over 50% of the subjects were suffering from Cd exposure as their UCd levels far exceeded the national standard threshold of 5.000 μg/g creatinine (cr). Further analysis indicated that Uβ2-MG was more sensitive than UNAG for renal dysfunction. The BMDL for UCd was estimated as 3.486 U/g cr (male, where U is unit of enzyme) and 2.998 U/g cr (female) for UNAG. The BMDL for Uβ2-MG, which is released into urine from glomerulus after Cd exposure, was found to be 2.506 μg/g cr (male, where μg is the unit of microglobulin) and 2.236 μg/g cr (female).ConclusionsUβ2-MG is recommended as the sensitivity index for renal dysfunction, with 2.2 μg/g cr as the threshold for clinical diagnosis. Our findings suggest that Uβ2-MG is the better biomarker for exposure to Cd.
Highlights
Excess cadmium (Cd) intake poses a general risk to health and to the kidneys in particular
The estimated benchmark dose (BMD) low (BMDL) of urinary Cd (UCd) was 6.9 μg/g cr for urinary β2-microglobulin (Uβ2-MG) and 4.4 U/g cr for urinary N-acetyl-β-D-glucosidase (UNAG) in males and 8.1 μg/g cr for Uβ2-MG and 6.1 U/g cr for UNAG in females [24]
This study found that most participants at a Cdcontaminated site had suffered severe damage to their kidney function, and more than 50% were in a high-risk group for Cd pollution. Their UCd levels were significantly lower than the threshold suggested by World Health Organization and GOMOHC
Summary
Excess cadmium (Cd) intake poses a general risk to health and to the kidneys in particular. A range of factors (including age, years of exposure, and gender) that affect the relationship between Cd burden and the prevalence of kidney dysfunction have been determined to contribute the Cd threshold [12,13,14], but the interaction mechanism remains unclear. Li et al BMC Nephrology (2020) 21:385 diagnostically in this context [15, 16], including urinary N-acetyl-β-D-glucosidase (UNAG), urinary β2-microglobulin (Uβ2-MG), and urinary retinol binding protein (URBP) [17,18,19] These three are likely valid biomarkers due to their origin in the renal tubules or in glomeruli breakage under urinary (UCd) pressure [20,21,22]. It is not yet clear which is the most sensitive to UCd
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