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4652057 
Journal Article 
Urinary and blood cadmium and lead and kidney function: NHANES 2007-2012 
Buser, MC; Ingber, SZ; Raines, N; Fowler, DA; Scinicariello, F 
2016 
Yes 
International Journal of Hygiene and Environmental Health
ISSN: 1438-4639
EISSN: 1618-131X 
219 
3 
261-267 
English 
26852280 
WOS:000374198800004 
BACKGROUND: Cadmium (Cd) and lead (Pb) are widespread environmental contaminants that are known nephrotoxins. However, their nephrotoxic effects at low-environmental exposure levels are debated.

OBJECTIVE: We examined the association of blood Pb (B-Pb), blood Cd (B-Cd), urinary Pb (U-Pb) and urinary Cd (U-Cd) with estimated glomerular filtration rate (eGFR) and urinary albumin (ALB).

METHODS: We used multivariate linear regression to analyze the association between B-Pb, B-Cd, U-Pb, and U-Cd with eGFR and ALB in adult participants (≥20 years of age) in NHANES 2007-2012. The dataset was limited to NHANES individuals with both blood and urinary metal measurements.

RESULTS: We found a statistically significant inverse association between eGFR and B-Cd and statistically significant positive associations between eGFR and both U-Cd and U-Pb, as well as statistically significant associations between ALB and the 3rd and 4th quartiles of U-Cd.

CONCLUSIONS: The inverse association between eGFR and B-Cd, in conjunction with positive associations between eGFR and ALB with U-Cd, suggest that U-Cd measurement at low levels of exposure may result from changes in renal excretion of Cd due to kidney function and protein excretion. However, renal effects such as hyperfiltration from Cd-mediated kidney damage or creatinine-specific Cd effects cannot be excluded with this cross-sectional design. 
Blood cadmium; Blood lead; Urinary cadmium; Urinary lead; Estimated glomerular filtration rate; Albuminuria