期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 170, 期 9, 页码 1156-1164出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwp248
关键词
albuminuria; cadmium; creatinine; glomerular filtration rate; kidney diseases; lead; metals; nutrition surveys
资金
- National Institute of Environmental Health Sciences
- Johns Hopkins Center in Urban Environmental Health [P30 ES 03819]
- National Institute for Occupational Safety and Health
- Education and Research Center for Occupational Safety and Health at the Johns Hopkins Bloomberg School of Public Health) of the US National Institutes of Health [T42 OH0008428]
- [2 and 3 ES007198]
Environmental cadmium and lead exposures are widespread, and both metals are nephrotoxic at high exposure levels. Few studies have evaluated the associations between low-level cadmium and clinical renal outcomes, particularly with respect to joint cadmium and lead exposure. The geometric mean levels of blood cadmium and lead were 0.41 mu g/L (3.65 nmol/L) and 1.58 mu g/dL (0.076 mu mol/L), respectively, in 14,778 adults aged >= 20 years who participated in the National Health and Nutrition Examination Survey (1999-2006). After adjustment for survey year, sociodemographic factors, chronic kidney disease risk factors, and blood lead, the odds ratios for albuminuria (>= 30 mg/g creatinine), reduced estimated glomerular filtration rate (eGFR) (<60 mL/minute/1.73 m(2)), and both albuminuria and reduced eGFR were 1.92 (95% confidence interval (CI): 1.53, 2.43), 1.32 (95% CI: 1.04, 1.68), and 2.91 (95% CI: 1.76, 4.81), respectively, comparing the highest with the lowest blood cadmium quartiles. The odds ratios comparing participants in the highest with the lowest quartiles of both cadmium and lead were 2.34 (95% CI: 1.72, 3.18) for albuminuria, 1.98 (95% CI: 1.27, 3.10) for reduced eGFR, and 4.10 (95% CI: 1.58, 10.65) for both outcomes. These findings support consideration of cadmium and lead as chronic kidney disease risk factors in the general population and provide novel evidence of risk with environmental exposure to both metals.
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