The NOAEL Equivalent of Environmental Cadmium Exposure Associated with GFR Reduction and Chronic Kidney Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Collection and Analysis of Biological Specimens
2.3. Estimated Glomerular Filtration Rates (eGFR)
2.4. Normalization of ECd to Ecr and Ccr
2.5. Benchmark Dose Computation and Benchmark Dose–Response (BMR) Setting
2.6. Statistical Analysis
3. Results
3.1. Characterization of Cadmium Exposure by Sex and Smoking
3.2. Characterization of CKD Risk factors
3.3. Cadmium Excretion in Relation to the Risk of CKD
3.4. BMDL/BMDU Figures of ECd Associated with Reduced Glomerular Function
3.4.1. Ecr-Normalized Dataset
3.4.2. Ccr-Normalized Dataset
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameters | All subjects n 1189 (33.6% Smokers) | Males, n 493 (57.4% Smokers) | Females, n 696 (16.8% Smokers) | ||
---|---|---|---|---|---|
Nonsmokers n 210 | Smokers n 283 | Nonsmokers n 579 | Smokers n 117 | ||
Age, years | 43.2 ± 14.0 | 35.9 ± 13.0 | 45.0 ± 14.8 *** | 42.6 ± 12.9 | 54.2 ± 10.1 ### |
Hypertension (%) | 29.4 | 26.5 | 27.2 | 30.8 | 33.3 |
BMI, kg/m2 | 23.0 ± 3.9 | 22.4 ± 3.0 | 22.3 ± 3.4 | 23.8 ± 4.0 | 22.4 ± 4.6 # |
BMI groups (%) | |||||
12–18 | 10.5 | 9.2 | 12.2 * | 7.4 | 21.4 |
19–23 | 47.1 | 56.9 | 57.2 ** | 41.6 | 36.8 ### |
≥24 | 42.4 | 34.0 | 30.6 | 51.0 | 41.9 ### |
eGFR a, mL/min/1.73 m2 | 93.7 ± 20 | 96.6 ± 17.6 | 91.9 ± 22.1 | 95.9 ± 19.3 | 81.8 ± 22.0 ### |
eGFR ≤ 60 mL/min/1.73 m2 (%) | 6.2 | 2.4 | 8.8 ** | 4.3 | 16.2 ### |
eGFR, mL/min/1.73 m2 (%) b | |||||
>120 | 7.8 | 9.0 | 5.7 | 9.7 | 1.7 ### |
90–120 | 53.8 | 61.0 | 56.5 | 54.1 | 33.3 ### |
60–89 | 32.8 | 27.6 | 29.7 * | 32.8 | 49.6 ### |
30–59 | 5.0 | 1.9 | 7.1 ** | 3.3 | 13.7 |
15–29 | 0.6 | 0.5 | 1.1 | 0.2 | 1.7 |
Plasma creatinine, mg/dL | 0.88 ± 0.24 | 1.00 ± 0.21 | 1.00 ± 0.27 | 0.76 ± 0.16 | 0.82 ± 0.27 ## |
Urine creatinine, mg/dL | 104.4 ± 73.5 | 81.1 ± 78 | 107.0 ± 75.6 *** | 67.9 ± 68.9 | 79.8 ± 64.8 |
Urine Cd, µg/L | 0.94 ± 9.69 | 0.32 ± 5.96 | 1.73 ± 15.9 *** | 0.75 ± 6.46 | 4.84 ± 6.38 ### |
Normalized to Ecr as Ex/Ecr c | |||||
ECd/Ecr, µg/g creatinine | 0.64 ± 6.12 | 0.32 ± 3.29 | 0.94 ± 8.85 *** | 0.57 ± 4.62 | 1.83 ± 7.27 ### |
Normalized to Ccr as Ex/Ccr d | |||||
ECd/Ccr × 100, µg/L filtrate | 1.02 ± 8.19 | 0.39 ± 4.75 | 1.61 ± 12.61 *** | 0.83 ± 5.27 | 5.00 ± 9.36 ### |
Independent Variables/ Factors | Number of Subjects | a CKD | ||||
---|---|---|---|---|---|---|
β Coefficients | POR | 95% CI | p | |||
(SE) | Lower | Upper | ||||
Model 1 | ||||||
Log2[(ECd/Ecr) × 103], µg/g creatinine | 917 | 0.385 (0.072) | 1.470 | 1.276 | 1.692 | <0.001 |
Hypertension | 276 | 0.490 (0.312) | 1.632 | 0.885 | 3.008 | 0.117 |
Gender (female) | 562 | 0.028 (0.340) | 1.029 | 0.528 | 2.002 | 0.934 |
Smoking | 335 | 0.209 (0.337) | 1.232 | 0.637 | 2.383 | 0.536 |
BMI, kg/m2 | ||||||
12–18 | 99 | Referent | ||||
19–23 | 431 | 0.057 (0.426) | 1.058 | 0.459 | 2.439 | 0.894 |
≥24 | 387 | 1.033 (0/470) | 2.810 | 1.118 | 7.064 | 0.028 |
Age, years | ||||||
16–45 | 392 | Referent | ||||
46–55 | 348 | 2.655 (1.036) | 14.23 | 1.867 | 108.4 | 0.010 |
56–65 | 100 | 3.340 (1.059) | 28.21 | 3.538 | 224.9 | 0.002 |
66–87 | 77 | 4.950 (1.055) | 141.2 | 17.87 | 1116 | <0.001 |
Model 2 | ||||||
Log2[(ECd/Ccr) × 105], µg/L filtrate | 917 | 0.674 (0.107) | 1.962 | 1.589 | 2.422 | <0.001 |
Hypertension | 276 | 0.551 (0.326) | 1.735 | 0.916 | 3.287 | 0.091 |
Gender (female) | 562 | −0.174 (0.366) | 0.840 | 0.410 | 1.719 | 0.633 |
Smoking | 335 | −0.058 (0.351) | 0.944 | 0.474 | 1.879 | 0.869 |
BMI, kg/m2 | ||||||
12–18 | 99 | Referent | ||||
19–23 | 431 | 0.103 (0.457) | 1.109 | 0.452 | 2.717 | 0.822 |
≥24 | 387 | 1.147 (0.500) | 3.150 | 1.181 | 8.400 | 0.022 |
Age, years | ||||||
16–45 | 392 | Referent | ||||
46–55 | 348 | 2.298 (1.036) | 9.951 | 1.305 | 75.88 | 0.027 |
56–65 | 100 | 3.543 (1.062) | 34.57 | 4.312 | 277.2 | 0.001 |
66–87 | 77 | 5.292 (1.066) | 198.6 | 24.59 | 1605 | <0.001 |
Independent Variables/ Factors | Number of Subjects | a CKD | ||||
---|---|---|---|---|---|---|
β Coefficients | POR | 95% CI | p | |||
(SE) | Lower | Upper | ||||
Model 1 | ||||||
Age, years | 917 | 0.126 (0.016) | 1.135 | 1.100 | 1.170 | <0.001 |
BMI, kg/m2 | 917 | 0.082 (0.038) | 1.086 | 1.009 | 1.169 | 0.028 |
Gender (female) | 562 | 0.124 (0.337) | 1.132 | 0.585 | 2.190 | 0.713 |
Hypertension | 276 | 0.304 (0.310) | 1.355 | 0.738 | 2.486 | 0.327 |
Smoking | 335 | 0.173 (0.345) | 1.189 | 0.605 | 2.338 | 0.615 |
ECd/Ecr, µg/g creatinine | ||||||
≤0.37 | 358 | Referent | ||||
0.38–2.49 | 333 | 1.819 (0.565) | 6.164 | 2.035 | 18.67 | 0.001 |
≥2.5 | 226 | 2.362 (0.557) | 10.61 | 3.562 | 31.60 | <0.001 |
Model 2 | ||||||
Age, years | 917 | 0.141 (0.016) | 1.152 | 1.116 | 1.189 | <0.001 |
BMI, kg/m2 | 917 | 0.099 (0.039) | 1.104 | 1.023 | 1.191 | 0.011 |
Gender (female) | 562 | 0.191 (0.356) | 1.211 | .602 | 2.434 | 0.591 |
Hypertension | 276 | 0.240 (0.314) | 1.271 | 0.687 | 2.353 | 0.445 |
Smoking | 335 | −0.033 (0.359) | 0.968 | 0.479 | 1.956 | 0.927 |
ECd/Ccr, ng/L filtrate | ||||||
≤9.9 | 346 | Referent | ||||
10–49.9 | 326 | 1.470 (0.642) | 4.350 | 1.237 | 15.30 | 0.022 |
≥50 | 245 | 3.036 (0.637) | 20.82 | 5.979 | 72.52 | <0.001 |
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Satarug, S.; Đorđević, A.B.; Yimthiang, S.; Vesey, D.A.; Gobe, G.C. The NOAEL Equivalent of Environmental Cadmium Exposure Associated with GFR Reduction and Chronic Kidney Disease. Toxics 2022, 10, 614. https://doi.org/10.3390/toxics10100614
Satarug S, Đorđević AB, Yimthiang S, Vesey DA, Gobe GC. The NOAEL Equivalent of Environmental Cadmium Exposure Associated with GFR Reduction and Chronic Kidney Disease. Toxics. 2022; 10(10):614. https://doi.org/10.3390/toxics10100614
Chicago/Turabian StyleSatarug, Soisungwan, Aleksandra Buha Đorđević, Supabhorn Yimthiang, David A. Vesey, and Glenda C. Gobe. 2022. "The NOAEL Equivalent of Environmental Cadmium Exposure Associated with GFR Reduction and Chronic Kidney Disease" Toxics 10, no. 10: 614. https://doi.org/10.3390/toxics10100614