Table 1.

Exposure levels associated with kidney and bone effects.

Study population, age, reference	Exposure/outcomes
Sweden, n = 820, 53–64 years of age, Åkesson et al. 2005, 2006	Blood and urinary cadmium at 0.38 μg/L and 0.67 μg/g creatinine were associated with tubular impairment. Urinary cadmium at 0.8 μg/g creatinine was associated with glomerular impairment. Increased body burden of cadmium was associated with lowered bone mineral density, decreased serum parathyroid hormone and bone metabolism.
Thailand, n = 200, 16–60 years of age, Satarug et al. 2005	A 3-fold increase in body burden associated with 11%, 32%, and 61% increases the probability of having high blood pressure, renal injury, and tubular impairment.
Thailand, n = 224, 30–87 years of age, Teeyakasem et al. 2007	OR for tubular impairment was 10.6, comparing urinary cadmium 1–5 versus > 5 μg/g creatinine.
United States, n = 4,258, ≥ 50 years of age, Gallagher et al. 2008	A 1.43-fold increase in osteoporosis risk, comparing urinary cadmium 1 versus < 0.5 μg/g creatinine
Belgium, n = 294, mean age 49.2 years of age, Schutte et al. 2008b	A 2-fold increase in body burden associated with increased bone resorption, urinary calcium loss, decreased proximal forearm bone density, and low serum parathyroid hormone.
China, n = 148, 3-year observation, Wu et al. 2008	Progressive tubular and glomerular impairment was observed among those with urinary cadmium > 10 μg/g creatinine.
United Kingdom, n = 160, 18–86 years of age, Thomas et al. 2009	Risk for early renal effectsa was increased by 2.6-fold and 3.6-fold, comparing urinary cadmium 0.3 versus < 0.5 versus ≥ 0.5 μg/g creatinine.
United States, n = 14,778, > 20 years of age, Navas-Acien et al. 2009	Risk for albuminuria was 2.34 and risk for lowered glomerular filtration rate was 1.98, comparing those in the highest versus lowest quartiles of blood cadmium and lead.

OR, odds ratio.

^aEarly renal injury was defined as urinary NAG > 2 IU/g creatinine.