Skip to main content
NCBI home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2000 Oct;57(10):668–672. doi: 10.1136/oem.57.10.668

Low level exposure to cadmium and early kidney damage: the OSCAR study

L Jarup 1, L Hellstrom 1, T Alfven 1, M Carlsson 1, A Grubb 1, B Persson 1, C Pettersson 1, G Spang 1, A Schutz 1, C Elinder 1
PMCID: PMC1739874  PMID: 10984338

Abstract

OBJECTIVES—To study the dose-response relation between cadmium dose and renal tubular damage in a population of workers and people environmentally or occupationally exposed to low concentrations of cadmium.
METHODS—Early kidney damage in 1021 people, occupationally or environmentally exposed to cadmium, was assessed from cadmium in urine to estimate dose, and protein HC (α1-microglobulin) in urine to assess tubular proteinuria.
RESULTS—There was an age and sex adjusted correlation between cadmium in urine and urinary protein HC. The prevalence of tubular proteinuria ranged from 5% among unexposed people to 50% in the most exposed group. The corresponding prevalence odds ratio was 6.0 (95% confidence interval (95% CI) 1.6 to 22) for the highest exposure group, adjusted for age and sex. Multiple logistic regression analysis showed an increasing prevalence of tubular proteinuria with urinary cadmium as well as with age. After adjustment to the mean age of the study population (53 years), the results show an increased prevalence of 10% tubular proteinuria (taking into account a background prevalence of 5%) at a urinary cadmium concentration of 1.0 nmol/mmol creatinine.
CONCLUSION—Renal tubular damage due to exposure to cadmium develops at lower levels of cadmium body burden than previously anticipated.


Keywords: cadmium; environmental; tubular damage

Full Text

The Full Text of this article is available as a PDF (150.6 KB).

Selected References

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

  1. Buchet J. P., Lauwerys R., Roels H., Bernard A., Bruaux P., Claeys F., Ducoffre G., de Plaen P., Staessen J., Amery A. Renal effects of cadmium body burden of the general population. Lancet. 1990 Sep 22;336(8717):699–702. doi: 10.1016/0140-6736(90)92201-r. [DOI] [PubMed] [Google Scholar]
  2. Fels L. M., Bundschuh I., Gwinner W., Jung K., Pergande M., Graubaum H. J., Price R. G., Taylor S. A., De Broe M. E., Nuyts G. D. Early urinary markers of target nephron segments as studied in cadmium toxicity. Kidney Int Suppl. 1994 Nov;47:S81–S88. [PubMed] [Google Scholar]
  3. Granerus G., Aurell M. Reference values for 51Cr-EDTA clearance as a measure of glomerular filtration rate. Scand J Clin Lab Invest. 1981 Oct;41(6):611–616. doi: 10.3109/00365518109090505. [DOI] [PubMed] [Google Scholar]
  4. Hotz P., Buchet J. P., Bernard A., Lison D., Lauwerys R. Renal effects of low-level environmental cadmium exposure: 5-year follow-up of a subcohort from the Cadmibel study. Lancet. 1999 Oct 30;354(9189):1508–1513. doi: 10.1016/s0140-6736(99)91145-5. [DOI] [PubMed] [Google Scholar]
  5. Järup L., Berglund M., Elinder C. G., Nordberg G., Vahter M. Health effects of cadmium exposure--a review of the literature and a risk estimate. Scand J Work Environ Health. 1998;24 (Suppl 1):1–51. [PubMed] [Google Scholar]
  6. Järup L., Elinder C. G. Dose-response relations between urinary cadmium and tubular proteinuria in cadmium-exposed workers. Am J Ind Med. 1994 Dec;26(6):759–769. doi: 10.1002/ajim.4700260605. [DOI] [PubMed] [Google Scholar]
  7. Järup L., Persson B., Elinder C. G. Blood cadmium as an indicator of dose in a long-term follow-up of workers previously exposed to cadmium. Scand J Work Environ Health. 1997 Feb;23(1):31–36. doi: 10.5271/sjweh.175. [DOI] [PubMed] [Google Scholar]
  8. Kido T., Honda R., Yamada Y., Tsuritani I., Ishizaki M., Nogawa K. alpha 1-Microglobulin determination in urine for the early detection of renal tubular dysfunctions caused by exposure to cadmium. Toxicol Lett. 1985 Feb-Mar;24(2-3):195–201. doi: 10.1016/0378-4274(85)90057-8. [DOI] [PubMed] [Google Scholar]
  9. Kjellström T., Evrin P. E., Rahnster B. Dose-response analysis of cadmium-induced tubular proteinuria: a study of urinary beta2-microglobulin excretion among workers in a battery factory. Environ Res. 1977 Apr;13(2):303–317. doi: 10.1016/0013-9351(77)90106-2. [DOI] [PubMed] [Google Scholar]
  10. Kjellström T. Mechanism and epidemiology of bone effects of cadmium. IARC Sci Publ. 1992;(118):301–310. [PubMed] [Google Scholar]
  11. Kowal N. E., Zirkes M. Urinary cadmium and beta 2-microglobulin: normal values and concentration adjustment. J Toxicol Environ Health. 1983 Apr-Jun;11(4-6):607–624. doi: 10.1080/15287398309530371. [DOI] [PubMed] [Google Scholar]
  12. Lauwerys R., Bernard A., Cardenas A. Monitoring of early nephrotoxic effects of industrial chemicals. Toxicol Lett. 1992 Dec;64-65 Spec No:33–42. doi: 10.1016/0378-4274(92)90170-o. [DOI] [PubMed] [Google Scholar]
  13. Mueller P. W., Paschal D. C., Hammel R. R., Klincewicz S. L., MacNeil M. L., Spierto B., Steinberg K. K. Chronic renal effects in three studies of men and women occupationally exposed to cadmium. Arch Environ Contam Toxicol. 1992 Jul;23(1):125–136. doi: 10.1007/BF00226005. [DOI] [PubMed] [Google Scholar]
  14. Niederstadt C., Steinhoff J. Die Nieren im Alter. Z Gerontol Geriatr. 1997 May-Jun;30(3):200–207. [PubMed] [Google Scholar]
  15. Nogawa K., Kobayashi E., Honda R. A study of the relationship between cadmium concentrations in urine and renal effects of cadmium. Environ Health Perspect. 1979 Feb;28:161–168. doi: 10.1289/ehp.7928161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Staessen J. A., Roels H. A., Emelianov D., Kuznetsova T., Thijs L., Vangronsveld J., Fagard R. Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Public Health and Environmental Exposure to Cadmium (PheeCad) Study Group. Lancet. 1999 Apr 3;353(9159):1140–1144. doi: 10.1016/s0140-6736(98)09356-8. [DOI] [PubMed] [Google Scholar]
  17. Tencer J., Thysell H., Andersson K., Grubb A. Stability of albumin, protein HC, immunoglobulin G, kappa- and lambda-chain immunoreactivity, orosomucoid and alpha 1-antitrypsin in urine stored at various conditions. Scand J Clin Lab Invest. 1994 May;54(3):199–206. doi: 10.1080/00365519409088425. [DOI] [PubMed] [Google Scholar]
  18. Tencer J., Thysell H., Grubb A. Analysis of proteinuria: reference limits for urine excretion of albumin, protein HC, immunoglobulin G, kappa- and lambda-immunoreactivity, orosomucoid and alpha 1-antitrypsin. Scand J Clin Lab Invest. 1996 Dec;56(8):691–700. doi: 10.3109/00365519609088816. [DOI] [PubMed] [Google Scholar]
  19. Tohyama C., Kobayashi E., Saito H., Sugihara N., Nakano A., Mitane Y. Urinary alpha 1-microglobulin as an indicator protein of renal tubular dysfunction caused by environmental cadmium exposure. J Appl Toxicol. 1986 Jun;6(3):171–178. doi: 10.1002/jat.2550060307. [DOI] [PubMed] [Google Scholar]
  20. Yamanaka O., Kobayashi E., Nogawa K., Suwazono Y., Sakurada I., Kido T. Association between renal effects and cadmium exposure in cadmium-nonpolluted area in Japan. Environ Res. 1998 Apr;77(1):1–8. doi: 10.1006/enrs.1998.3839. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES