Skip to main content
NCBI home page
British Journal of Industrial Medicine logoLink to British Journal of Industrial Medicine
. 1989 Nov;46(11):755–764. doi: 10.1136/oem.46.11.755

Health significance of cadmium induced renal dysfunction: a five year follow up.

H A Roels 1, R R Lauwerys 1, J P Buchet 1, A M Bernard 1, A Vos 1, M Oversteyns 1
PMCID: PMC1009864  PMID: 2686749

Abstract

To assess the health significance of the early renal changes after chronic exposure to cadmium, 23 workers removed from exposure because of the discovery of an increased urinary excretion of beta 2-microglobulin or retinol binding protein, or both, have been examined once a year for five years. Eight of these workers had also an increased albuminuria. These workers had been exposed to cadmium for six to 41.7 years (mean 25 years) and their first follow up examination took place when they had been removed from exposure for six years on average. At that time, their mean age was 58.6 years (range: 45.5-68.1). It has been confirmed that the proteinuria induced by cadmium is irreversible. The most important finding, however, is a significant increase of creatinine and beta 2-microglobulin concentrations in serum with time, indicating a progressive reduction of the glomerular filtration rate despite removal from exposure. It is estimated that on average this rate has decreased by 31 ml/min/1.73 m2 during the five year follow up study. This decrease is significantly greater (about five times) than that accounted for by aging and is not more pronounced in workers with impaired renal function at the start of the study than in those presenting only with subclinical signs of renal damage. Serum alkaline phosphatase activity also increases significantly with time. In conclusion, the present study indicates that the early renal changes induced by cadmium should be regarded as adverse effects; they are predictive of an exacerbation of the age related decline of the glomerular filtration rate.

Full text

PDF
755

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alessio L., Bertazzi P. A., Monelli O., Toffoletto F. Free erythrocyte protoporphyrin as an indicator of the biological effect of lead in adult males. III. Behavior of free erythrocyte protoporphyrin in workers with past lead exposure. Int Arch Occup Environ Health. 1976 Dec 15;38(2):77–86. doi: 10.1007/BF00378618. [DOI] [PubMed] [Google Scholar]
  2. Bernard A. M., Lauwerys R. R. Continuous-flow system for automation of latex immunoassay by particle counting. Clin Chem. 1983 Jun;29(6):1007–1011. [PubMed] [Google Scholar]
  3. Bernard A., Buchet J. P., Roels H., Masson P., Lauwerys R. Renal excretion of proteins and enzymes in workers exposed to cadmium. Eur J Clin Invest. 1979 Feb;9(1):11–22. doi: 10.1111/j.1365-2362.1979.tb01662.x. [DOI] [PubMed] [Google Scholar]
  4. Bernard A., Lauwerys R., Gengoux P. Characterization of the proteinuria induced by prolonged oral administration of cadmium in female rats. Toxicology. 1981;20(4):345–357. doi: 10.1016/0300-483x(81)90041-x. [DOI] [PubMed] [Google Scholar]
  5. Bernard A., Roels H., Hubermont G., Buchet J. P., Masson P. L., Lauwerys R. R. Characterization of the proteinuria in cadmium-exposed workers. Int Arch Occup Environ Health. 1976 Oct 21;38(1):19–30. doi: 10.1007/BF00378317. [DOI] [PubMed] [Google Scholar]
  6. Braren V., Goddard J., Brill A. B., Touya J. J. Beta-2-microglobulin as renal diagnostic agent. Urology. 1979 Jun;13(6):624–628. doi: 10.1016/0090-4295(79)90385-6. [DOI] [PubMed] [Google Scholar]
  7. Buchet J. P., Roels H., Bernard A., Lauwerys R. Assessment of renal function of workers exposed to inorganic lead, calcium or mercury vapor. J Occup Med. 1980 Nov;22(11):741–750. [PubMed] [Google Scholar]
  8. Buchet J. P., Roels H., Bernard A., Lauwerys R. Assessment of renal function of workers simultaneously exposed to inorganic lead and cadmium. J Occup Med. 1981 May;23(5):348–352. [PubMed] [Google Scholar]
  9. Elinder C. G., Edling C., Lindberg E., Kågedal B., Vesterberg O. Assessment of renal function in workers previously exposed to cadmium. Br J Ind Med. 1985 Nov;42(11):754–760. doi: 10.1136/oem.42.11.754. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Elinder C. G., Edling C., Lindberg E., Kågedal B., Vesterberg O. beta 2-Microglobulinuria among workers previously exposed to cadmium: follow-up and dose-response analyses. Am J Ind Med. 1985;8(6):553–564. doi: 10.1002/ajim.4700080607. [DOI] [PubMed] [Google Scholar]
  11. Garattini S., Bertani T., Remuzzi G. What is the basis for the use of steroids in the treatment of idiopathic membranous nephropathy? Nephron. 1987;45(1):1–6. doi: 10.1159/000184062. [DOI] [PubMed] [Google Scholar]
  12. Heinegård D., Tiderström G. Determination of serum creatinine by a direct colorimetric method. Clin Chim Acta. 1973 Feb 12;43(3):305–310. doi: 10.1016/0009-8981(73)90466-x. [DOI] [PubMed] [Google Scholar]
  13. Kult J., Lämmlein C., Röckel A., Heidland A. Beta2-Mikroglobulin im Serum--ein Parameter des Glomerulumfiltrates. Dtsch Med Wochenschr. 1974 Aug 23;99(34):1686–1688. doi: 10.1055/s-0028-1108030. [DOI] [PubMed] [Google Scholar]
  14. Lauwerys R. R., Bernard A. M. Cadmium and the kidney. Br J Ind Med. 1986 Jul;43(7):433–435. doi: 10.1136/oem.43.7.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lauwerys R. R., Bernard A., Roels H. A., Buchet J. P., Viau C. Characterization of cadmium proteinuria in man and rat. Environ Health Perspect. 1984 Mar;54:147–152. doi: 10.1289/ehp.8454147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lauwerys R. R., Buchet J. P., Roels H. A., Brouwers J., Stanescu D. Epidemiological survey of workers exposed to cadmium. Arch Environ Health. 1974 Mar;28(3):145–148. doi: 10.1080/00039896.1974.10666455. [DOI] [PubMed] [Google Scholar]
  17. Lauwerys R., Delbroeck R., Vens M. D. Automated analysis of delta-aminolaevulinic acid in urine. Clin Chim Acta. 1972 Sep;40(2):443–447. doi: 10.1016/0009-8981(72)90356-7. [DOI] [PubMed] [Google Scholar]
  18. Nogawa K., Kobayashi E., Honda R., Ishizaki A., Kawano S., Matsuda H. Renal dysfunctions of inhabitants in a cadmium-polluted area. Environ Res. 1980 Oct;23(1):13–23. doi: 10.1016/0013-9351(80)90088-2. [DOI] [PubMed] [Google Scholar]
  19. Nogawa K., Tsuritani I., Kido T., Honda R., Yamada Y., Ishizaki M. Mechanism for bone disease found in inhabitants environmentally exposed to cadmium: decreased serum 1 alpha, 25-dihydroxyvitamin D level. Int Arch Occup Environ Health. 1987;59(1):21–30. doi: 10.1007/BF00377675. [DOI] [PubMed] [Google Scholar]
  20. O'Flynn R. R. Psychiatric research in occupational medicine: the future of an illusion? Br J Ind Med. 1988 Jan;45(1):1–2. doi: 10.1136/oem.45.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Piscator M. Long-term observations on tubular and glomerular function in cadmium-exposed persons. Environ Health Perspect. 1984 Mar;54:175–179. doi: 10.1289/ehp.8454175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Portman R. J., Kissane J. M., Robson A. M. Use of beta 2 microglobulin to diagnose tubulo-interstitial renal lesions in children. Kidney Int. 1986 Jul;30(1):91–98. doi: 10.1038/ki.1986.156. [DOI] [PubMed] [Google Scholar]
  23. Roels H. A., Buchet J. P., Lauwerys R., Bruaux P., Claeys-Thoreau F., Lafontaine A., van Overschelde J., Verduyn G. Lead and cadmium absorption among children near a nonferrous metal plant: a follow-up study of a test case. Environ Res. 1978 Apr;15(2):290–308. doi: 10.1016/0013-9351(78)90105-6. [DOI] [PubMed] [Google Scholar]
  24. Roels H. A., Lauwerys R. R., Buchet J. P., Bernard A., Chettle D. R., Harvey T. C., Al-Haddad I. K. In vivo measurement of liver and kidney cadmium in workers exposed to this metal: its significance with respect to cadmium in blood and urine. Environ Res. 1981 Oct;26(1):217–240. doi: 10.1016/0013-9351(81)90199-7. [DOI] [PubMed] [Google Scholar]
  25. Roels H. A., Lauwerys R. R., Buchet J. P., Bernard A. Environmental exposure to cadmium and renal function of aged women in three areas of Belgium. Environ Res. 1981 Feb;24(1):117–130. doi: 10.1016/0013-9351(81)90138-9. [DOI] [PubMed] [Google Scholar]
  26. Roels H., Djubgang J., Buchet J. P., Bernard A., Lauwerys R. Evolution of cadmium-induced renal dysfunction in workers removed from exposure. Scand J Work Environ Health. 1982 Sep;8(3):191–200. doi: 10.5271/sjweh.2476. [DOI] [PubMed] [Google Scholar]
  27. Roels H., Lauwerys R., Dardenne A. N. The critical level of cadmium in human renal cortex: a reevaluation. Toxicol Lett. 1983 Mar;15(4):357–360. doi: 10.1016/0378-4274(83)90156-x. [DOI] [PubMed] [Google Scholar]
  28. Wedeen R. P., Malik D. K., Batuman V. Detection and treatment of occupational lead nephropathy. Arch Intern Med. 1979 Jan;139(1):53–57. [PubMed] [Google Scholar]
  29. Wibell L., Evrin P. E., Berggård I. Serum 2 -microglobulin in renal disease. Nephron. 1973;10(5):320–331. doi: 10.1159/000180203. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Industrial Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES