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Low-level cadmium exposure and effects on kidney function

Artikel i vetenskaplig tidskrift
Författare Maria Wallin
Gerd Sällsten
T. Lundh
Lars Barregård
Publicerad i Occupational and Environmental Medicine
Volym 71
Nummer/häfte 12
Sidor 848-854
ISSN 1351-0711
Publiceringsår 2014
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
Sidor 848-854
Språk en
Länkar dx.doi.org/10.1136/oemed-2014-10227...
Ämnesord GLOMERULAR-FILTRATION-RATE, URINARY CADMIUM, RENAL-FUNCTION, DISEASE, ASSOCIATIONS, POPULATION, CREATININE, BIOMARKERS, EXCRETION, PERFORMANCE, Public, Environmental & Occupational Health
Ämneskategorier Klinisk medicin

Sammanfattning

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.

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