Related Experiment Video
Updated: Mar 27, 2026
Removal of Trace Elements by Cupric Oxide Nanoparticles from Uranium In Situ Recovery Bleed Water and Its Effect on Cell Viability
Published on: June 21, 2015
Association of Urinary Cadmium with Mortality in Patients at a Coronary Care Unit
Ching-Wei Hsu1,2,3, Cheng-Hao Weng1,2,3, Dan-Tzu Lin-Tan1,2,3
1Department of Nephrology, Division of Clinical Toxicology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Insights
Elevated day 1 urinary excretion of cadmium (D1-UE-Cd) in coronary care unit (CCU) patients is a significant predictor of mortality. This cadmium biomarker offers a more accurate prediction than existing scoring systems.
Area of Science:
- Environmental toxicology
- Clinical toxicology
- Critical care medicine
Background:
- Cadmium exposure is a growing public health concern.
- Assessing the impact of cadmium on patient outcomes is crucial for clinical management.
Purpose of the Study:
- To determine the effect of day 1 urinary excretion of cadmium (D1-UE-Cd) on mortality in patients admitted to a coronary care unit (CCU).
Main Methods:
- 323 CCU patients were enrolled, with urine and blood samples collected within 24 hours of admission.
- Demographic data, clinical diagnoses, and hospital mortality were recorded.
- Established mortality prediction scoring systems were calculated and compared with D1-UE-Cd levels.
Main Results:
- Non-survivors (n=34) exhibited higher D1-UE-Cd levels compared to survivors (n=289).
- D1-UE-Cd was independently associated with increased CCU mortality (HR 3.160, p < 0.001).
- D1-UE-Cd demonstrated high predictive accuracy (AUC 0.87), outperforming established scoring systems.
Conclusions:
- Day 1 urinary excretion of cadmium is a novel, objective, and accurate predictor of hospital mortality in CCU patients.
- This biomarker surpasses the predictive capabilities of current clinical scoring systems.
- Further research is warranted to elucidate the physiological mechanisms linking cadmium exposure to mortality in critically ill patients.
Background:
Determine the effect of the day 1 urinary excretion of cadmium (D1-UE-Cd) on mortality of patients admitted to a coronary care unit (CCU).
Methods:
A total of 323 patients were enrolled in this 6-month study. Urine and blood samples were taken within 24 h after CCU admission. Demographic data, clinical diagnoses, and hospital mortality were recorded. The scores of established systems for prediction of mortality in critically ill patients were calculated.
Results:
Compared with survivors (n = 289), non-survivors (n = 34) had higher levels of D1-UE-Cd. Stepwise multiple linear regression analysis indicated that D1-UE-Cd was positively associated with pulse rate and level of aspartate aminotransferase, but negatively associated with serum albumin level. Multivariate Cox analysis, with adjustment for other significant variables and measurements from mortality scoring systems, indicated that respiratory rate and D1-UE-Cd were independent and significant predictors of mortality. For each 1 μg/day increase of D1-UE-Cd, the hazard ratio for CCU mortality was 3.160 (95% confidence interval: 1.944-5.136, p < 0.001). The chi-square value of Hosmer-Lemeshow goodness-of-fit test for D1-UE-Cd was 10.869 (p = 0.213). The area under the receiver operating characteristic curve for D1-UE-Cd was 0.87 (95% confidence interval: 0.81-0.93).
Conclusions:
The D1-UE-Cd, an objective variable with no inter-observer variability, accurately predicted hospital mortality of CCU patients and outperformed other established scoring systems. Further studies are needed to determine the physiological mechanism of the effect of cadmium on mortality in CCU patients.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:24Chronic Kidney Disease II: Clinical Manifestations
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease III: Clinical Manifestations
01:28Urinary Tract Calculi V: Nursing Management