Chronic exposure to cadmium is associated with a marked reduction in glomerular filtration rate.

Abstract

BACKGROUND:

Urinary 20-hydroxyeicosatetraenoic acid (20-HETE) has been associated with hypertension in women with elevated urinary cadmium (Cd) excretion rates. The present study investigates the urinary Cd and 20-HETE levels in relation to the estimated glomerular filtration rate (eGFR) and albumin excretion in men and women.

METHODS:

A population-based, cross-sectional study, which included 225 women and 84 men aged 33-55 years, was conducted in a rural area known to be polluted with Cd.

RESULTS:

In all subjects, lower eGFR values were associated with higher urinary Cd excretion (P = 0.030), and tubulopathy markers N-acetyl-β-d-glucosaminidase (P < 0.001) and β2-microglobulin (β2-MG) (P < 0.001). On average, the hypertensive subjects with the highest quartile of urinary Cd had eGFR values of 12 and 17 mL/min/1.73 m2 lower than that in the hypertensive (P = 0.009) and normotensive subjects (P < 0.001) with the lowest quartile of urinary Cd, respectively. In men, urinary albumin was inversely associated with 20-HETE (β = -0.384, P < 0.001), while showing a moderately positive association with systolic blood pressure (SBP) (β = 0.302, P = 0.037). In women, urinary albumin was not associated with 20-HETE (P = 0.776), but was associated with tubulopathy, reflected by elevated urinary excretion of β2-MG (β = 0.231, P = 0.002).

CONCLUSIONS:

Tubulopathy is a determinant of albumin excretion in women, while 20-HETE and SBP are determinants of urinary albumin excretion in men. Associations of chronic exposure to Cd with marked eGFR decline and renal tubular injury seen in both Cd-exposed men and women add to mounting research data that links Cd to the risk of developing chronic kidney disease.

• Authors: Soisungwan Satarug, Kanyarat Boonprasert, Glenda C Gobe, Ronnatrai Ruenweerayut, David W Johnson, Kesara Na-Bangchang, David A Vesey
• Journal: Clinical kidney journal (Clin Kidney J) Vol. 12 Issue 4 Pg. 468-475 (Aug 2019) ISSN: 2048-8505 [Print] England
• PMID: 31384436 (Publication Type: Journal Article)