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International journal of molecular sciences
May 20, 2023;24 (10):

Chronic Kidney Disease Induced by Cadmium and Diabetes: A Quantitative Case-Control Study.

Supabhorn Yimthiang, David A Vesey, Phisit Pouyfung, Tanaporn Khamphaya, Glenda C Gobe, Soisungwan Satarug
Author Information
  1. Supabhorn Yimthiang: Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand. ORCID
  2. David A Vesey: The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia. ORCID
  3. Phisit Pouyfung: Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand.
  4. Tanaporn Khamphaya: Occupational Health and Safety, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand.
  5. Glenda C Gobe: The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia. ORCID
  6. Soisungwan Satarug: The Centre for Kidney Disease Research, Translational Research Institute, Brisbane 4102, Australia.
PMID: 37240395 DOI: 10.3390/ijms24109050

Abstract

Kidney disease associated with chronic cadmium (Cd) exposure is primarily due to proximal tubule cell damage. This results in a sustained decline in glomerular filtration rate (GFR) and tubular proteinuria. Similarly, diabetic kidney disease (DKD) is marked by albuminuria and a declining GFR and both may eventually lead to kidney failure. The progression to kidney disease in diabetics exposed to Cd has rarely been reported. Herein, we assessed Cd exposure and the severity of tubular proteinuria and albuminuria in 88 diabetics and 88 controls, matched by age, gender and locality. The overall mean blood and Cd excretion normalized to creatinine clearance (C) as E/C were 0.59 µg/L and 0.0084 µg/L filtrate (0.96 µg/g creatinine), respectively. Tubular dysfunction, assessed by β-microglobulin excretion rate normalized to C(E/C) was associated with both diabetes and Cd exposure. Doubling of Cd body burden, hypertension and a reduced estimated GFR (eGFR) increased the risks for a severe tubular dysfunction by 1.3-fold, 2.6-fold, and 84-fold, respectively. Albuminuria did not show a significant association with E/C, but hypertension and eGFR did. Hypertension and a reduced eGFR were associated with a 3-fold and 4-fold increases in risk of albuminuria. These findings suggest that even low levels of Cd exposure exacerbate progression of kidney disease in diabetics.

Keywords

GFR albuminuria cadmium diabetes diabetic nephropathy tubular proteinuria β2-microglobulin

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MeSH Term

Humans
Cadmium
Albuminuria
Case-Control Studies
Creatinine
Diabetic Nephropathies
Renal Insufficiency, Chronic
Renal Insufficiency
Proteinuria
Glomerular Filtration Rate
Hypertension
Diabetes Mellitus

Chemicals

Cadmium
Creatinine
Journal Article

Word Cloud

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