Low-level cadmium exposure and effects on kidney function
Artikel i vetenskaplig tidskrift, 2014

Objectives The nephrotoxicity of cadmium at low levels of exposure, measured by urinary cadmium, has recently been questioned since co-excretion of cadmium and proteins may have causes other than cadmium toxicity. The aim of this study was to explore the relation between kidney function and low or moderate cadmium levels, measured directly in kidney biopsies. Methods We analysed cadmium in kidney biopsies (K-Cd), blood (B-Cd) and urine (U-Cd) from 109 living kidney donors in a cross-sectional study. We measured glomerular filtration rate (GFR), cystatin C in serum, albumin, -2-microglobulin (B2M), retinol-binding protein (RBP), -1-microglobulin (A1M), N-acetyl--d-glucosaminidase and kidney injury molecule 1 (KIM-1) in 24h and overnight urine. Results We found significant positive associations between A1M excretion and K-Cd in multiple regression models including age, sex, weight, smoking and urinary flow rate. This association was also present in never-smokers. A1M was also positively associated with B-Cd and U-Cd. GFR and the other biomarkers of kidney function were not associated with K-Cd. GFR estimated from serum cystatin C showed a very poor correlation with measured GFR. KIM-1, RBP and possibly albumin were positively associated with U-Cd, but only in overnight urine. No associations were found with B2M. Conclusions Our results suggest that A1M in urine is a sensitive biomarker for effects of low-level cadmium exposure. A few associations between other renal biomarkers and U-Cd, but not K-Cd, were probably caused by physiological co-excretion or chance.

URINARY CADMIUM

RENAL-FUNCTION

CREATININE

ASSOCIATIONS

POPULATION

Environmental & Occupational Health

PERFORMANCE

GLOMERULAR-FILTRATION-RATE

EXCRETION

Public

DISEASE

BIOMARKERS

Författare

Maria Wallin

Göteborgs universitet

Gerd Sallsten

Göteborgs universitet

T. Lundh

Lars Barregård

Göteborgs universitet

Occupational and Environmental Medicine

1351-0711 (ISSN) 1470-7926 (eISSN)

Vol. 71 848-854

Ämneskategorier

Klinisk medicin

DOI

10.1136/oemed-2014-102279