Blood Cadmium and Estimated Glomerular Filtration Rate in Korean Adults

Background: Cadmium is a nephrotoxicant at high exposure levels. Few studies have evaluated the role of cadmium in kidney function at low-exposure levels. Objective: We evaluated the association of blood cadmium with estimated glomerular filtration rate (eGFR) in the Korean adult population. Methods: We evaluated 1,909 adults ≥ 20 years of age who participated in the 2005 Korean National Health and Nutrition Examination Survey and had blood cadmium determinations. eGFR was calculated using the Modification of Diet in Renal Disease equation. Results: Blood cadmium geometric means were 1.57 μg/L for men and 1.49 μg/L for women. The difference in eGFR levels that compared participants in the highest versus lowest cadmium tertiles, after multivariable adjustment, was –1.85 [95% confidence interval (CI): –3.55, –0.16] mL/min per 1.73 m2 in women and 0.67 (–1.16, 2.50) mL/min per 1.73 m2 in men. Among men, the association between blood cadmium and eGFR was modified by blood lead levels (p-value for interaction = 0.048). The fully adjusted differences in eGFR levels for a 2-fold increase in blood cadmium levels were –1.14 (–3.35, 1.07) and 1.84 (0.54, 3.14) mL/min per 1.73 m2 in men with blood lead levels below and above the median (2.75 μg/dL), respectively. Conclusion: Elevated blood cadmium levels were associated with lower eGFR in women, which supports the role of cadmium as a risk factor for chronic kidney disease. In men, there was no overall association, although elevated blood cadmium levels were associated with higher eGFR levels in men with high blood lead levels and nonstatistically associated with lower eGFR levels in men with low blood lead levels.

• Publication year

  2011

• Venue

  Environmental Health Perspectives

• Publication date

  2011-08-11

• Fields of study

  Medicine, Environmental Science

• Identifiers
  DOI 10.1289/ehp.1003054PMID 21835726PMCID 3261971
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Associations of low-level urine cadmium with kidney function in lead workers

  2010cited by this paper
• Chronic kidney disease and metabolic syndrome in a general Korean population: the Third Korea National Health and Nutrition Examination Survey (KNHANES III) Study.

  2010influential reference
• Heavy Metal Contamination of Arable Soil and Corn Plant in the Vicinity of a Zinc Smelting Factory and Stabilization by Liming

  2009influential reference
• Current status of cadmium as an environmental health problem.

  2009cited by this paper
• Time-dependent association between metabolic syndrome and risk of CKD in Korean men without hypertension or diabetes.

  2009cited by this paper
• Investigation on Health Effects of an Abandoned Metal Mine

  2008cited by this paper
• Early Kidney Damage in a Population Exposed to Cadmium and Other Heavy Metals

  2008cited by this paper
• Renal function decrement in type 2 diabetes mellitus patients in Cipto Mangunkusumo Hospital.

  2008cited by this paper
• Contamination by Cd, Cu, Pb, and Zn in mine wastes from abandoned metal mines classified as mineralization types in Korea

  2008cited by this paper
• Prevalence of chronic kidney disease in the United States.

  2007cited by this paper
• Glomerular hyperfiltration: a new marker of metabolic risk.

  2007cited by this paper
• Handbook on the toxicology of metals, 3rd Edition

  2007influential reference
• Assessing kidney function--measured and estimated glomerular filtration rate.

  2006cited by this paper
• Loss of glomerular polyanion correlated with albuminuria in experimental cadmium nephropathy

  2006cited by this paper
• [Human multi-route exposure assessment of lead and cadmium for Korean volunteers].

  2006cited by this paper
• Tubular and Glomerular Kidney Effects in Swedish Women with Low Environmental Cadmium Exposure

  2005influential reference
• Renal and Neurologic Effects of Cadmium, Lead, Mercury, and Arsenic in Children: Evidence of Early Effects and Multiple Interactions at Environmental Exposure Levels

  2005cited by this paper
• Chronic kidney disease: the global challenge

  2005cited by this paper
• Characteristics of population with normal serum creatinine impaired renal function and: the validation of a MDRD formula in a healthy general population.

  2005cited by this paper
• High-protein diets: potential effects on the kidney in renal health and disease.

  2004cited by this paper
• The gender differences in health effects of environmental cadmium exposure and potential mechanisms

  2004cited by this paper
• Environmental epidemiological study and estimation of benchmark dose for renal dysfunction in a cadmium-polluted area in China

  2004influential reference
• The effects of weight loss on renal function in patients with severe obesity.

  2003cited by this paper
• Blood lead and chronic kidney disease in the general United States population: results from NHANES III.

  2003cited by this paper
• Associations of lead biomarkers with renal function in Korean lead workers

  2003cited by this paper
• Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000.

  2003cited by this paper
• Recommendations for the screening and management of patients with chronic kidney disease.

  2002cited by this paper
• Cadmium exposure and end-stage renal disease.

  2001cited by this paper
• Possible effects of environmental cadmium exposure on kidney function in the Japanese general population

  2000influential reference
• Glomerular hemodynamics in severe obesity.

  2000cited by this paper
• Renal effects of low-level environmental cadmium exposure: 5-year follow-up of a subcohort from the Cadmibel study.

  1999cited by this paper
• A More Accurate Method To Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation

  1999cited by this paper
• Health effects of cadmium exposure - a review of the literature and a risk estimate

  1998cited by this paper
• Health effects of cadmium exposure--a review of the literature and a risk estimate.

  1998cited by this paper
• Dietary intake of cadmium and lead among the general population in Korea.

  1995cited by this paper
• Decreased glomerular filtration rate in solderers exposed to cadmium.

  1995cited by this paper
• Renal function and hyperfiltration capacity in lead smelter workers with high bone lead.

  1994cited by this paper
• Incorporation of [35S]sulfate into glomerular membranes of rats chronically exposed to cadmium and its relation with urinary glycosaminoglycans and proteinuria.

  1992cited by this paper
• Recruitment experience in the full-scale phase of the Modification of Diet in Renal Disease Study.

  1991influential reference
• Design and statistical issues of the Modification of Diet in Renal Disease Trial. The Modification of Diet in Renal Disease Study Group.

  1991influential reference
• The modification of diet in renal disease study group

  1991influential reference
• Estimation of Average Concentration in the Presence of Nondetectable Values

  1990cited by this paper
• Epidemiology of renal tubular dysfunction in the inhabitants of a cadmium-polluted area in the Jinzu River basin in Toyama Prefecture.

  1987influential reference
• Early glomerular hyperfiltration in insulin-dependent diabetics and late nephropathy.

  1986cited by this paper
• Short‐term Inhibition of Prostaglandin Synthesis has no Effect on the Elevated Glomerular Filtration Rate of Early Insulin‐dependent Diabetes

  1985cited by this paper
• Glomerular hyperfiltration in diabetes mellitus.

  1985cited by this paper
• Glomerular hyperfiltration in diabetes mellitus.

  1985cited by this paper
• Short-term protein loading in assessment of patients with renal disease.

  1984cited by this paper
• Renal functional reserve in humans. Effect of protein intake on glomerular filtration rate.

  1983cited by this paper
• Cadmium nephropathy.

  1981cited by this paper
• Recent progress and perspectives in cadmium health effects studies.

  1980influential reference
• Handbook on the Toxicology of Metals

  1979influential reference
• Urinary beta2-microglobulin excretion among people exposed to cadmium in the general environment: an epidemiological study in cooperation between Japan and Sweden.

  1977influential reference
• American Journal of Epidemiology Original Contribution Blood Cadmium and Lead and Chronic Kidney Disease in Us Adults: a Joint Analysis

  year unknowninfluential reference

• Assessing Causal Evidence Beyond Correlation: Linking Cadmium Exposure to Disease, Using Bradford Hill Framework

  2026cites this paper
• A Comparative Study on the Paradoxical Relationship Between Heavy Metal Exposure and Kidney Function

  2025cites this paper
• Exploring the Association Between Potentially Toxic Elements and Chronic Kidney Disease of Unknown Etiology in Eastern Uttar Pradesh, India

  2025cites this paper
• Relationship between Serum Cadmium Concentration and Lung Function: A Study Using Korea National Health and Nutrition Examination Survey Data

  2025cites this paper
• Associations between urinary rare Earth elements with renal function: Findings from a cross-sectional study in Guangxi, China.

  2024cites this paper
• Association between exposure to perfluoroalkyl and polyfluoroalkyl substances with estimated glomerular filtration rate: Mediating role of serum albumin.

  2024cites this paper
• Pattern Recognition of Trace Element vs Heavy Elements in Patients with Membranous Nephropathy

  2024cites this paper
• Effects of Blood Cadmium Levels on Blood Pressure and the Risk of Hypertension in a Community-Based Elderly Population

  2024cites this paper
• Assessment of human exposure to cadmium and its nephrotoxicity in the Chinese population.

  2024cites this paper
• Chronic Kidney Disease Induced by Cadmium and Diabetes: A Quantitative Case-Control Study

  2023cites this paper
• Cadmium-Induced Tubular Dysfunction in Type 2 Diabetes: A Population-Based Cross-Sectional Study

  2023cites this paper
• Prenatal cadmium exposure impairs neural tube closure via inducing excessive apoptosis in neuroepithelium.

  2023cites this paper
• Association of cadmium environmental exposure with chronic kidney disease: A systematic review and meta-analysis.

  2023cites this paper
• Cadmium exposure is associated with chronic kidney disease in a superfund site lead smelter community in Dallas, Texas

  2023cites this paper
• Nutraceuticals as Alternative Approach against Cadmium-Induced Kidney Damage: A Narrative Review

  2023cites this paper
• Detoxification of Cadmium on Albino Rats (Rattus norvegicus) with Natural Chelator of Fruiting Body Extract of Ganoderma lucidum

  2023cites this paper
• Combined Exposure to Multiple Metals and Kidney Function in a Midlife and Elderly Population in China: A Prospective Cohort Study

  2023cites this paper
• Effects of Environmental Exposure to Cadmium and Lead on the Risks of Diabetes and Kidney Dysfunction

  2022influential citation
• Microcystin-LR Combined with Cadmium Exposures and the Risk of Chronic Kidney Disease: A Case-Control Study in Central China.

  2022cites this paper
• Multiple Targets of Toxicity in Environmental Exposure to Low-Dose Cadmium

  2022cites this paper
• Ca Minerals and Oral Bioavailability of Pb, Cd, and As from Indoor Dust in Mice: Mechanisms and Health Implications

  2022cites this paper
• A systematic review of adverse health effects associated with oral cadmium exposure.

  2022cites this paper
• Clinical biochemical parameters associated with the exposure to multiple environmental metals in residents from Kabwe, Zambia.

  2021cites this paper
• The association between estimated glomerular filtration rate and cadmium exposure: An 8-year follow-up study.

  2021cites this paper
• Increased expression of apoptotic markers in human full-term placenta after exposure to elevated environmental cadmium levels during pregnancy

  2021cites this paper
• Associations between exposure to heavy metals and the risk of chronic kidney disease: a systematic review and meta-analysis

  2021influential citation
• Heavy Metal Content of Rice Meals Sold in a Nigerian Market Population with a High Prevalence of Hypertension

  2021cites this paper
• Effects of Exposure to Lead and Cadmium on Health of Inhabitants of Abandoned Metal Mine Area in Korea

  2021cites this paper
• The association between life-time dietary cadmium intake from rice and chronic kidney disease.

  2021cites this paper
• Analysis of Cadmium, Mercury, and Lead Concentrations in Erythrocytes of Renal Transplant Recipients from Northwestern Poland

  2021cites this paper
• Gender‐biased kidney damage in mice following exposure to tobacco cigarette smoke: More protection in premenopausal females

  2020cites this paper
• Cadmium-Induced Renal Cell Toxicity Is Associated With MicroRNA Deregulation

  2020cites this paper
• Stable isotope fractionation of cadmium in the soil-rice-human continuum.

  2020cites this paper
• Associations of Blood Heavy Metals with Uric Acid in the Korean General Population: Analysis of Data from the 2016–2017 Korean National Health and Nutrition Examination Survey

  2020cites this paper
• A Comparison of the Nephrotoxicity of Low Doses of Cadmium and Lead

  2020cites this paper
• Urinary cadmium clearance, its relationship to glomerular filtration rate and implications for cadmium epidemiology

  2019influential citation
• Analysis of urinary trace element levels in general population of Wuhan in central China

  2019cites this paper
• Cadmium-binding proteins in human blood plasma.

  2019cites this paper
• Polymorphisms in gene MMP-2 modify the association of cadmium exposure with hypertension risk.

  2019cites this paper
• Association of co-exposure to heavy metals with renal function in a hypertensive population.

  2018cites this paper
• Renal Toxicology/Nephrotoxicity of Metals and Nanometallic Particles: Arsenic, Bismuth, Cadmium, Chromium, Indium, Lead, Platinum, Uranium, and Metallic Mixtures

  2018cites this paper
• The association between dietary cadmium exposure and renal dysfunction – the benchmark dose estimation of reference levels: the ChinaCad study

  2018cites this paper
• Is renal tubular cadmium toxicity clinically relevant?

  2018cites this paper
• Risk assessment of effects of cadmium on human health (IUPAC Technical Report)

  2018cites this paper
• Urinary Cadmium Threshold to Prevent Kidney Disease Development

  2018cites this paper
• Dietary Cadmium Intake and Its Effects on Kidneys

  2018cites this paper
• Kidney Cadmium Toxicity, Diabetes and High Blood Pressure: The Perfect Storm.

  2017cites this paper
• Chronic Kidney Disease and Exposure to Nephrotoxic Metals

  2017cites this paper
• Low-Level Environmental Cadmium Exposure Induces Kidney Tubule Damage in the General Population of Korean Adults

  2017cites this paper
• Toxicity of cadmium and its health risks from leafy vegetable consumption.

  2017cites this paper
• Association of urinary cadmium with risk of diabetes: a meta-analysis

  2017cites this paper
• Current health risk assessment practice for dietary cadmium: Data from different countries.

  2017cites this paper
• Applying Cadmium Relative Bioavailability to Assess Dietary Intake from Rice to Predict Cadmium Urinary Excretion in Nonsmokers.

  2017cites this paper
• Cadmium modulates hematopoietic stem and progenitor cells and skews toward myelopoiesis in mice.

  2016cites this paper
• Running title: Cytochrome P450 and Cd-induced stress in human kidney cells

  2016cites this paper
• Cadmium Exposure is Associated with the Prevalence of Dyslipidemia

  2016cites this paper
• Tubular and glomerular kidney effects in the Chinese general population with low environmental cadmium exposure.

  2016cites this paper
• Cadmium or cadmium compounds and chronic kidney disease in workers and the general population: a systematic review

  2016cites this paper
• The stress response of human proximal tubule cells to cadmium involves up-regulation of haemoxygenase 1 and metallothionein but not cytochrome P450 enzymes.

  2016cites this paper
• Imprégnation aux métaux et métalloïdes en population générale du Nord–Pas-de-Calais : niveaux, déterminants et liens avec le débit de filtration glomérulaire

  2016cites this paper
• Application of Cloud Point Extraction for Cadmium in Biological Samples of Occupationally Exposed Workers: Relation Between Cadmium Exposure and Renal Lesion

  2015cites this paper
• Cadmium, lead and mercury concentrations and their influence on morphological parameters in blood donors from different age groups from southern Poland.

  2015cites this paper
• Renal Effects of Exposure to Metals

  2015cites this paper
• Chapter 32 – Cadmium

  2015cites this paper
• Environmental exposures, socioeconomics, disparities, and the kidneys.

  2015cites this paper
• Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines

  2015cites this paper
• Kidney Biomarkers Associated with Blood Lead, Mercury, and Cadmium in Premenopausal Women: A Prospective Cohort Study

  2015influential citation
• Non-Renal Effects and the Risk Assessment of Environmental Cadmium Exposure

  2014cites this paper
• Dietary cadmium exposure and chronic kidney disease: a population-based prospective cohort study of men and women.

  2014influential citation
• Cadmium, type 2 diabetes, and kidney damage in a cohort of middle-aged women.

  2014cites this paper
• Serum cadmium levels in a sample of blood donors in the Western Amazon, Brazil, 2010-2011.

  2014cites this paper
• Blood lead and cadmium levels and renal function in Korean adults

  2014cites this paper
• Socio-economic impact in CKD.

  2013cites this paper
• Kidney Function and Tobacco Smoke Exposure in US Adolescents WHAT'S KNOWN ON THIS SUBJECT: Active smoking and secondhand smoke are associated with chronic kidney disease in adults. No data are available for children.

  2013cites this paper
• Cadmium exposure induces hematuria in Korean adults.

  2013cites this paper
• Cadmium exposure and risk of kidney effects and bone fractures : population-based studies in England and Sweden

  2013cites this paper
• Cadmium Exposure and Clinical Cardiovascular Disease: A Systematic Review

  2013cites this paper
• Kidney Function and Tobacco Smoke Exposure in US Adolescents

  2013cites this paper
• Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data.

  2012cites this paper
• Toxicological Profile for Cadmium

  2012cites this paper
• Menthol Cigarettes, Race/Ethnicity, and Biomarkers of Tobacco Use in U.S. Adults: The 1999–2010 National Health and Nutrition Examination Survey (NHANES)

  2012cites this paper
• Effect of Bauxite Mineralized Soil on Residual Metal Levels in Some Post Harvest Food Crops in Jamaica

  2012cites this paper
• Cadmium Risk Assessment in Relation to Background Risk of Chronic Kidney Disease

  2012cites this paper