Blood cadmium and lead and chronic kidney disease in US sdults: A joint analysis

Virginia Marie Weaver, Ana Navas Acien, Maria Tellez-Plaza, Eliseo Guallar, Paul Muntner, Ellen Silbergeld, Bernard Jaar

Research output: Contribution to journalArticlepeer-review

222 Scopus citations


Environmental cadmium and lead exposures are widespread, and both metals are nephrotoxic at high exposure levels. Few studies have evaluated the associations between low-level cadmium and clinical renal outcomes, particularly with respect to joint cadmium and lead exposure. The geometric mean levels of blood cadmium and lead were 0.41 μg/L (3.65 nmol/L) and 1.58 μg/dL (0.076 μmol/L), respectively, in 14,778 adults aged ≥20 years who participated in the National Health and Nutrition Examination Survey (1999-2006). After adjustment for survey year, sociodemographic factors, chronic kidney disease risk factors, and blood lead, the odds ratios for albuminuria (≥30 mg/g creatinine), reduced estimated glomerular filtration rate (eGFR) (<60 mL/minute/1.73 m2), and both albuminuria and reduced eGFR were 1.92 (95% confidence interval (CI): 1.53, 2.43), 1.32 (95% CI: 1.04, 1.68), and 2.91 (95% CI: 1.76, 4.81), respectively, comparing the highest with the lowest blood cadmium quartiles. The odds ratios comparing participants in the highest with the lowest quartiles of both cadmium and lead were 2.34 (95% CI: 1.72, 3.18) for albuminuria, 1.98 (95% CI: 1.27, 3.10) for reduced eGFR, and 4.10 (95% CI: 1.58, 10.65) for both outcomes. These findings support consideration of cadmium and lead as chronic kidney disease risk factors in the general population and provide novel evidence of risk with environmental exposure to both metals.

Original languageEnglish (US)
Pages (from-to)1156-1164
Number of pages9
JournalAmerican journal of epidemiology
Issue number9
StatePublished - 2009


  • Albuminuria
  • Cadmium
  • Creatinine
  • Glomerular filtration rate
  • Kidney diseases
  • Lead
  • Metals
  • Nutrition surveys

ASJC Scopus subject areas

  • Epidemiology


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