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Occup Environ Med. Oct 2000; 57(10): 668–672.
PMCID: PMC1739874

Low level exposure to cadmium and early kidney damage: the OSCAR study


OBJECTIVES—To study the dose-response relation between cadmium dose and renal tubular damage in a population of workers and people environmentally or occupationally exposed to low concentrations of cadmium.
METHODS—Early kidney damage in 1021 people, occupationally or environmentally exposed to cadmium, was assessed from cadmium in urine to estimate dose, and protein HC (α1-microglobulin) in urine to assess tubular proteinuria.
RESULTS—There was an age and sex adjusted correlation between cadmium in urine and urinary protein HC. The prevalence of tubular proteinuria ranged from 5% among unexposed people to 50% in the most exposed group. The corresponding prevalence odds ratio was 6.0 (95% confidence interval (95% CI) 1.6 to 22) for the highest exposure group, adjusted for age and sex. Multiple logistic regression analysis showed an increasing prevalence of tubular proteinuria with urinary cadmium as well as with age. After adjustment to the mean age of the study population (53 years), the results show an increased prevalence of 10% tubular proteinuria (taking into account a background prevalence of 5%) at a urinary cadmium concentration of 1.0 nmol/mmol creatinine.
CONCLUSION—Renal tubular damage due to exposure to cadmium develops at lower levels of cadmium body burden than previously anticipated.

Keywords: cadmium; environmental; tubular damage

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Selected References

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  • Lauwerys R, Bernard A, Cardenas A. Monitoring of early nephrotoxic effects of industrial chemicals. Toxicol Lett. 1992 Dec;64-65 Spec No:33–42. [PubMed]
  • Järup L, Berglund M, Elinder CG, Nordberg G, Vahter M. Health effects of cadmium exposure--a review of the literature and a risk estimate. Scand J Work Environ Health. 1998;24 (Suppl 1):1–51. [PubMed]
  • Kjellström T. Mechanism and epidemiology of bone effects of cadmium. IARC Sci Publ. 1992;(118):301–310. [PubMed]
  • Buchet JP, Lauwerys R, Roels H, Bernard A, Bruaux P, Claeys F, Ducoffre G, de Plaen P, Staessen J, Amery A, et al. Renal effects of cadmium body burden of the general population. Lancet. 1990 Sep 22;336(8717):699–702. [PubMed]
  • Kjellström T, Evrin PE, Rahnster B. Dose-response analysis of cadmium-induced tubular proteinuria: a study of urinary beta2-microglobulin excretion among workers in a battery factory. Environ Res. 1977 Apr;13(2):303–317. [PubMed]
  • Järup L, Elinder CG. Dose-response relations between urinary cadmium and tubular proteinuria in cadmium-exposed workers. Am J Ind Med. 1994 Dec;26(6):759–769. [PubMed]
  • Tencer J, Thysell H, Andersson K, Grubb A. Stability of albumin, protein HC, immunoglobulin G, kappa- and lambda-chain immunoreactivity, orosomucoid and alpha 1-antitrypsin in urine stored at various conditions. Scand J Clin Lab Invest. 1994 May;54(3):199–206. [PubMed]
  • Tencer J, Thysell H, Grubb A. Analysis of proteinuria: reference limits for urine excretion of albumin, protein HC, immunoglobulin G, kappa- and lambda-immunoreactivity, orosomucoid and alpha 1-antitrypsin. Scand J Clin Lab Invest. 1996 Dec;56(8):691–700. [PubMed]
  • Kido T, Honda R, Yamada Y, Tsuritani I, Ishizaki M, Nogawa K. alpha 1-Microglobulin determination in urine for the early detection of renal tubular dysfunctions caused by exposure to cadmium. Toxicol Lett. 1985 Feb-Mar;24(2-3):195–201. [PubMed]
  • Tohyama C, Kobayashi E, Saito H, Sugihara N, Nakano A, Mitane Y. Urinary alpha 1-microglobulin as an indicator protein of renal tubular dysfunction caused by environmental cadmium exposure. J Appl Toxicol. 1986 Jun;6(3):171–178. [PubMed]
  • Järup L, Persson B, Elinder CG. Blood cadmium as an indicator of dose in a long-term follow-up of workers previously exposed to cadmium. Scand J Work Environ Health. 1997 Feb;23(1):31–36. [PubMed]
  • Fels LM, Bundschuh I, Gwinner W, Jung K, Pergande M, Graubaum HJ, Price RG, Taylor SA, De Broe ME, Nuyts GD, et al. Early urinary markers of target nephron segments as studied in cadmium toxicity. Kidney Int Suppl. 1994 Nov;47:S81–S88. [PubMed]
  • Mueller PW, Paschal DC, Hammel RR, Klincewicz SL, MacNeil ML, Spierto B, Steinberg KK. Chronic renal effects in three studies of men and women occupationally exposed to cadmium. Arch Environ Contam Toxicol. 1992 Jul;23(1):125–136. [PubMed]
  • Yamanaka O, Kobayashi E, Nogawa K, Suwazono Y, Sakurada I, Kido T. Association between renal effects and cadmium exposure in cadmium-nonpolluted area in Japan. Environ Res. 1998 Apr;77(1):1–8. [PubMed]
  • Granerus G, Aurell M. Reference values for 51Cr-EDTA clearance as a measure of glomerular filtration rate. Scand J Clin Lab Invest. 1981 Oct;41(6):611–616. [PubMed]
  • Niederstadt C, Steinhoff J. Die Nieren im Alter. Z Gerontol Geriatr. 1997 May-Jun;30(3):200–207. [PubMed]
  • Kowal NE, Zirkes M. Urinary cadmium and beta 2-microglobulin: normal values and concentration adjustment. J Toxicol Environ Health. 1983 Apr-Jun;11(4-6):607–624. [PubMed]
  • Nogawa K, Kobayashi E, Honda R. A study of the relationship between cadmium concentrations in urine and renal effects of cadmium. Environ Health Perspect. 1979 Feb;28:161–168. [PMC free article] [PubMed]
  • Hotz P, Buchet JP, Bernard A, Lison D, Lauwerys R. Renal effects of low-level environmental cadmium exposure: 5-year follow-up of a subcohort from the Cadmibel study. Lancet. 1999 Oct 30;354(9189):1508–1513. [PubMed]
  • Staessen JA, Roels HA, Emelianov D, Kuznetsova T, Thijs L, Vangronsveld J, Fagard R. Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Public Health and Environmental Exposure to Cadmium (PheeCad) Study Group. Lancet. 1999 Apr 3;353(9159):1140–1144. [PubMed]

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