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Cadmium and Lead Exposure, Nephrotoxicity, and Mortality
Soisungwan Satarug1, Glenda C Gobe1,2,3, David A Vesey1,4
1Kidney Disease Research Collaborative, The University of Queensland Faculty of Medicine and Translational Research Institute, Woolloongabba, Brisbane 4102, Australia.
Toxics
|October 17, 2020
Summary
Environmental exposure to cadmium (Cd) and lead (Pb) poses health risks, even at low levels. Current safety limits for these toxic metals may not sufficiently protect against chronic kidney disease and other serious health issues.
Area of Science:
- Environmental Health
- Toxicology
- Public Health
Background:
- Populations worldwide are exposed to low-to-moderate environmental levels of cadmium (Cd) and lead (Pb).
- Coexposure to Cd and Pb can result in synergistic nephrotoxicity, where each metal enhances the toxicity of the other.
- Existing tolerable intake levels and urinary Cd threshold limits may not adequately protect against adverse health effects.
Purpose of the Study:
- To review current health risks associated with environmental Cd and Pb exposure.
- To discuss dietary sources, intake levels, and methods for quantifying exposure.
- To evaluate the association between Cd and Pb exposure and risks of chronic kidney disease (CKD) and mortality.
Main Methods:
- Review of epidemiological studies on Cd and Pb coexposure and health outcomes.
- Summary of dietary intake data from various countries (U.S., Spain, Korea, Germany, China).
- Discussion of biomarkers for Cd and Pb exposure (urine, blood, plasma, erythrocytes).
Main Results:
- Cd intake below recommended safe levels (23.2 μg/day) increased CKD risk by 73%.
- Urinary Cd levels significantly lower than the threshold limit were linked to increased risks of CKD, heart disease mortality, cancer, and Alzheimer's disease.
- Pb exposure may potentiate Cd-induced nephrotoxicity, and vice versa.
Conclusions:
- Current tolerable intake levels and urinary Cd thresholds offer insufficient protection against Cd and Pb toxicity.
- Excessive Cd excretion suggests potential tubular injury.
- Minimizing environmental exposure to Cd and Pb is crucial due to their interactive toxicity and health risks.
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