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Open AccessArticle

A Comparison of the Nephrotoxicity of Low Doses of Cadmium and Lead

National Research Centre for Environmental Toxicology, The University of Queensland, Coopers Plains, Brisbane 4108, Australia
Kidney Disease Research Collaborative, The University of Queensland Faculty of Medicine and Translational Research Institute, Woolloongabba, Brisbane 4102, Australia
School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia
NHMRC Centre of Research Excellence for CKD.QLD, UQ Health Sciences, Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
Department of Laboratory Medicine, Chulalongkorn University Faculty of Medicine, Bangkok 10330, Thailand
Department of Nephrology, Princess Alexandra Hospital, Brisbane 4075, Australia
Author to whom correspondence should be addressed.
Toxics 2020, 8(1), 18;
Received: 13 January 2020 / Revised: 6 February 2020 / Accepted: 25 February 2020 / Published: 2 March 2020
(This article belongs to the Special Issue Toxic Metals, Chronic Diseases and Related Cancers)
Environmental exposure to moderate-to-high levels of cadmium (Cd) and lead (Pb) is associated with nephrotoxicity. In comparison, the health impacts of chronic low-level exposure to Cd and Pb remain controversial. The aim of this study was to therefore evaluate kidney dysfunction associated with chronic low-level exposure to Cd and Pb in a population of residents in Bangkok, Thailand. The mean age and the estimated glomerular filtration rate (eGFR) for 392 participants (195 men and 197 women) were 34.9 years and 104 mL/min/1.73 m2, respectively, while the geometric mean concentrations of urinary Cd and Pb were 0.25 μg/L (0.45 μg/g of creatinine) and 0.89 μg/L (1.52 μg/g of creatinine), respectively. In a multivariable regression analysis, the eGFR varied inversely with blood urea nitrogen in both men (β = −0.125, p = 0.044) and women (β = −0.170, p = 0.008), while inverse associations of the eGFR with urinary Cd (β = −0.132, p = 0.043) and urinary Pb (β = −0.130, p = 0.044) were seen only in women. An increased urinary level of Cd to the median level of 0.38 μg/L (0.44 μg/g of creatinine) was associated with a decrease in the eGFR by 4.94 mL/min/1.73 m2 (p = 0.011). The prevalence odds of a reduced eGFR rose 2.5-, 2.9- and 2.3-fold in the urinary Cd quartile 3 (p = 0.013), the urinary Cd quartile 4 (p = 0.008), and the urinary Pb quartile 4 (p = 0.039), respectively. This study suggests that chronic exposure to low-level Cd is associated with a decline in kidney function and that women may be more susceptible than men to nephrotoxicity due to an elevated intake of Cd and Pb. View Full-Text
Keywords: cadmium; creatinine clearance; creatinine excretion; glomerular filtration rate; lead; nephrotoxicity cadmium; creatinine clearance; creatinine excretion; glomerular filtration rate; lead; nephrotoxicity
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Satarug, S.; Gobe, G.C.; Ujjin, P.; Vesey, D.A. A Comparison of the Nephrotoxicity of Low Doses of Cadmium and Lead. Toxics 2020, 8, 18.

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