**5. Conclusions**

A dose–response relationship between the external dose of Cd over a lifetime and mortality for renal diseases was found in women living in the Cd-polluted Kakehashi River basin, suggesting clear evidence of the impact of environmental Cd exposure on increased mortality from renal diseases in women.

**Author Contributions:** Conceptualization, M.N. and Y.S.; data curation, K.N. and M.S.; formal analysis, M.S.; funding acquisition, T.K.; methodology, K.N.; project administration, T.K. and H.N.; supervision, H.N.; writing—original draft, M.N.; writing—review and editing, Y.S. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was supported by a gran<sup>t</sup> for aid from the Agency of Environment for Health E ffects due to Heavy Metal Exposure 2009–2012 and 2013–2015, 2016–2018.

**Acknowledgments:** We thank the sta ff of Minami-Kaga Prefecture Public Health O ffice and Komatsu City Municipal O ffice in Ishikawa Prefecture, Japan, for their collaboration in the follow-up survey.

**Conflicts of Interest:** The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.
