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Current Environmental Health Reports

, Volume 5, Issue 4, pp 453–463 | Cite as

Toxic Metals and Chronic Kidney Disease: a Systematic Review of Recent Literature

  • Emily C. Moody
  • Steven G. Coca
  • Alison P. SandersEmail author
Metals and Health (A Barchowsky, Section Editor)
  • 95 Downloads
Part of the following topical collections:
  1. Topical Collection on Metals and Health

Abstract

Purpose of Review

Arsenic (As), cadmium (Cd), and lead (Pb) are ubiquitous toxicants with evidence of adverse kidney impacts at high exposure levels. There is less evidence whether environmental exposure to As, Cd, or Pb plays a role in development of chronic kidney disease (CKD). We conducted a systematic review to summarize the recent epidemiologic literature examining the relationship between As, Cd, or Pb with CKD.

Recent Findings

We included peer-reviewed studies published in English between January 2013 and April 2018 for As and Cd, and all dates prior to April 2018 for Pb. We imposed temporality requirements for both the definition of CKD (as per NKF-KDOQI guidelines) and environmental exposures prior to disease diagnosis. Our assessment included cohort, case-control or cross-sectional study designs that satisfied 5 inclusion criteria. We included a total of eight articles of which three, two, and four studies examined the effects of As, Cd, or Pb, respectively.

Summary

Studies of As exposure consistently reported positive association with CKD incidence; studies of Pb exposure were mixed. We found little evidence of association between Cd exposure and CKD. Additional well-designed prospective cohort studies are needed and we present recommendations for future studies.

Keywords

Arsenic Cadmium Lead Chronic kidney disease Glomerular filtration rate 

Abbreviations

As

Arsenic

BLL

Blood lead level

BMI

Body mass index

BP

Blood pressure

Cd

Cadmium

eGFR

estimated Glomerular Filtration Rate

Pb

Lead

SBP

Systolic blood pressure

CKDu

Chronic kidney disease of unknown etiology

ESRD

End-stage renal disease

Notes

Funding Information

This work was supported in part by funding from the Mount Sinai Children’s Center Foundation and the NIH (K99ES027508 and T32HD049311).

Compliance with Ethical Standards

Conflict of Interest

Steven Coca reports personal fees from Quark Biopharma, personal fees from Goldfinch Bio, personal fees from Janssen Pharma, personal fees from Renalytix.AI, personal fees from pulseData, outside the submitted work. Emily C. Moody and Alison P. Sanders declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. 1.
    Prozialeck WC, Edwards JR. Mechanisms of cadmium-induced proximal tubule injury: new insights with implications for biomonitoring and therapeutic interventions. J Pharmacol Exp Ther. 2012;343(1):2–12.CrossRefGoogle Scholar
  2. 2.
    Robles-Osorio ML, Sabath-Silva E, Sabath E. Arsenic-mediated nephrotoxicity. Ren Fail. 2015;37(4):542–7.CrossRefGoogle Scholar
  3. 3.
    Ekong EB, Jaar BG, Weaver VM. Lead-related nephrotoxicity: a review of the epidemiologic evidence. Kidney Int. 2006;70(12):2074–84.CrossRefGoogle Scholar
  4. 4.
    Nigra AE, Sanchez TR, Nachman KE, Harvey D, Chillrud SN, Graziano JH, et al. The effect of the Environmental Protection Agency maximum contaminant level on arsenic exposure in the USA from 2003 to 2014: an analysis of the National Health and Nutrition Examination Survey (NHANES). Lancet Public Health. 2017;2(11):e513–e21.CrossRefGoogle Scholar
  5. 5.
    Tsoi MF, Cheung CL, Cheung TT, Cheung BM. Continual decrease in blood lead level in Americans: United States National Health Nutrition and Examination Survey 1999-2014. Am J Med. 2016;129(11):1213–8.CrossRefGoogle Scholar
  6. 6.
    Global Burden of Disease Study C. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743–800.CrossRefGoogle Scholar
  7. 7.
    •• Zheng L, Kuo CC, Fadrowski J, Agnew J, Weaver VM, Navas-Acien A. Arsenic and chronic kidney disease: a systematic review. Curr Environ Health Rep. 2014;1(3):192–207. This systematic review and meta-analysis of arsenic exposure and CKD (up to 2014) included 24 studies. They used an expanded definition of CKD otucome measures, and found evidence for a positive association between arsenic exposure and CKD mortality.CrossRefGoogle Scholar
  8. 8.
    •• Byber K, Lison D, Verougstraete V, Dressel H, Hotz P. Cadmium or cadmium compounds and chronic kidney disease in workers and the general population: a systematic review. Crit Rev Toxicol. 2016;46(3):191–240. This extensive systematic review (up to 2014) of cadmium and CKD examined evidence from a total of 34 cohort, case-control, and case-series studies. The authors included a broader case definition of CKD and more relaxed exposure-outcome temporality than the intentionally narrow criteria applied herein.CrossRefGoogle Scholar
  9. 9.
    Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63(5):713–35.CrossRefGoogle Scholar
  10. 10.
    Weaver VM, Fadrowski JJ, Jaar BG. Global dimensions of chronic kidney disease of unknown etiology (CKDu): a modern era environmental and/or occupational nephropathy? BMC Nephrol. 2015;16:145.CrossRefGoogle Scholar
  11. 11.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefGoogle Scholar
  12. 12.
    Sommar JN, Svensson MK, Bjor BM, Elmstahl SI, Hallmans G, Lundh T, et al. End-stage renal disease and low level exposure to lead, cadmium and mercury; a population-based, prospective nested case-referent study in Sweden. Environ Health. 2013;12:9.CrossRefGoogle Scholar
  13. 13.
    Diyabalanage S, Fonseka S, Dasanayake D, Chandrajith R. Environmental exposures of trace elements assessed using keratinized matrices from patients with chronic kidney diseases of uncertain etiology (CKDu) in Sri Lanka. J Trace Elem Med Biol. 2017;39:62–70.CrossRefGoogle Scholar
  14. 14.
    Scharer K, Veits G, Brockhaus A, Ewers U. High lead content of deciduous teeth in chronic renal failure. Pediatr Nephrol. 1991;5(6):704–7.CrossRefGoogle Scholar
  15. 15.
    Zheng LY, Umans JG, Yeh F, Francesconi KA, Goessler W, Silbergeld EK, et al. The association of urine arsenic with prevalent and incident chronic kidney disease: evidence from the Strong Heart Study. Epidemiology. 2015;26(4):601–12.CrossRefGoogle Scholar
  16. 16.
    Hsu LI, Hsieh FI, Wang YH, Lai TS, Wu MM, Chen CJ, et al. Arsenic exposure from drinking water and the incidence of CKD in low to moderate exposed areas of Taiwan: a 14-year prospective study. Am J Kidney Dis. 2017;70(6):787–97.CrossRefGoogle Scholar
  17. 17.
    Thomas LD, Elinder CG, Wolk A, Akesson A. Dietary cadmium exposure and chronic kidney disease: a population-based prospective cohort study of men and women. Int J Hyg Environ Health. 2014;217(7):720–5.CrossRefGoogle Scholar
  18. 18.
    Evans M, Discacciati A, Quershi AR, Akesson A, Elinder CG. End-stage renal disease after occupational lead exposure: 20 years of follow-up. Occup Environ Med. 2017;74(6):396–401.CrossRefGoogle Scholar
  19. 19.
    Yu CC. Environmental exposure to lead and progression of chronic renal diseases: a four-year prospective longitudinal study. J Am Soc Nephrol. 2004;15(4):1016–22.CrossRefGoogle Scholar
  20. 20.
    Water NRCUSoAiD, editor. Biomarkers of arsenic exposure. Washington (DC): National Academies Press (US); 1999.Google Scholar
  21. 21.
    Hughes MF. Biomarkers of exposure: a case study with inorganic arsenic. Environ Health Perspect. 2006;114(11):1790–6.CrossRefGoogle Scholar
  22. 22.
    Vacchi-Suzzi C, Eriksen KT, Levine K, McElroy J, Tjonneland A, Raaschou-Nielsen O, et al. Dietary intake estimates and urinary cadmium levels in Danish postmenopausal women. PLoS One. 2015;10(9):e0138784.CrossRefGoogle Scholar
  23. 23.
    Julin B, Vahter M, Amzal B, Wolk A, Berglund M, Akesson A. Relation between dietary cadmium intake and biomarkers of cadmium exposure in premenopausal women accounting for body iron stores. Environ Health. 2011;10:105.CrossRefGoogle Scholar
  24. 24.
    Jarup L, Berglund M, Elinder CG, Nordberg G, Vahter M. Health effects of cadmium exposure--a review of the literature and a risk estimate. Scand J Work Environ Health. 1998;24(Suppl 1):1–51.PubMedGoogle Scholar
  25. 25.
    Chung S, Chung JH, Kim SJ, Koh ES, Yoon HE, Park CW, et al. Blood lead and cadmium levels and renal function in Korean adults. Clin Exp Nephrol. 2014;18(5):726–34.CrossRefGoogle Scholar
  26. 26.
    Swaddiwudhipong W, Nguntra P, Kaewnate Y, Mahasakpan P, Limpatanachote P, Aunjai T, et al. Human health effects from cadmium exposure: comparison between persons living in cadmium-contaminated and non-contaminated areas in northwestern Thailand. Southeast Asian J Trop Med Public Health. 2015;46(1):133–42.PubMedGoogle Scholar
  27. 27.
    Skroder H, Hawkesworth S, Kippler M, El Arifeen S, Wagatsuma Y, Moore SE, et al. Kidney function and blood pressure in preschool-aged children exposed to cadmium and arsenic--potential alleviation by selenium. Environ Res. 2015;140:205–13.CrossRefGoogle Scholar
  28. 28.
    Buser MC, Ingber SZ, Raines N, Fowler DA, Scinicariello F. Urinary and blood cadmium and lead and kidney function: NHANES 2007-2012. Int J Hyg Environ Health. 2016;219(3):261–7.CrossRefGoogle Scholar
  29. 29.
    Kim NH, Hyun YY, Lee KB, Chang Y, Ryu S, Oh KH, et al. Environmental heavy metal exposure and chronic kidney disease in the general population. J Korean Med Sci. 2015;30(3):272–7.CrossRefGoogle Scholar
  30. 30.
    Burm E, Ha M, Kwon HJ. Association between blood cadmium level and bone mineral density reduction modified by renal function in young and middle-aged men. J Trace Elem Med Biol. 2015;32:60–5.CrossRefGoogle Scholar
  31. 31.
    Al-Saleh I, Al-Rouqi R, Elkhatib R, Abduljabbar M, Al-Rajudi T. Risk assessment of environmental exposure to heavy metals in mothers and their respective infants. Int J Hyg Environ Health. 2017;220(8):1252–78.CrossRefGoogle Scholar
  32. 32.
    Wang D, Sun H, Wu Y, Zhou Z, Ding Z, Chen X, et al. Tubular and glomerular kidney effects in the Chinese general population with low environmental cadmium exposure. Chemosphere. 2016;147:3–8.CrossRefGoogle Scholar
  33. 33.
    Grau-Perez M, Pichler G, Galan-Chilet I, Briongos-Figuero LS, Rentero-Garrido P, Lopez-Izquierdo R, et al. Urine cadmium levels and albuminuria in a general population from Spain: a gene-environment interaction analysis. Environ Int. 2017;106:27–36.CrossRefGoogle Scholar
  34. 34.
    Jayasumana C, Gunatilake S, Siribaddana S. Simultaneous exposure to multiple heavy metals and glyphosate may contribute to Sri Lankan agricultural nephropathy. BMC Nephrol. 2015;16:103.CrossRefGoogle Scholar
  35. 35.
    Rambouskova J, Krskova A, Slavikova M, Cejchanova M, Cerna M. Blood levels of lead, cadmium, and mercury in the elderly living in institutionalized care in the Czech Republic. Exp Gerontol. 2014;58:8–13.CrossRefGoogle Scholar
  36. 36.
    Panhwar AH, Kazi TG, Naeemullah, Afridi HI, Shah F, Arain MB, et al. Evaluated the adverse effects of cadmium and aluminum via drinking water to kidney disease patients: application of a novel solid phase microextraction method. Environ Toxicol Pharmacol. 2016;43:242–7.CrossRefGoogle Scholar
  37. 37.
    Barbosa F, Tanus-Santos JE, Gerlach RF, Parsons PJ. A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. Environ Health Persp. 2005;113(12):1669–74.CrossRefGoogle Scholar
  38. 38.
    Chen WJ, Huang YL, Shiue HS, Chen TW, Lin YF, Huang CY, et al. Renin-angiotensin-aldosterone system related gene polymorphisms and urinary total arsenic is related to chronic kidney disease. Toxicol Appl Pharmacol. 2014;279(2):95–102.CrossRefGoogle Scholar
  39. 39.
    Ancona C, Bauleo L, Biscotti G, Bocca B, Caimi S, Cruciani F, et al. A survey on lifestyle and level of biomarkers of environmental exposure in residents in Civitavecchia (Italy). Ann Ist Super Sanita. 2016;52(4):488–94.PubMedGoogle Scholar
  40. 40.
    Arain MB, Kazi TG, Baig JA, Afridi HI, Sarajuddin, Brehman KD, et al. Co-exposure of arsenic and cadmium through drinking water and tobacco smoking: risk assessment on kidney dysfunction. Environ Sci Pollut Res Int. 2015;22(1):350–7.CrossRefGoogle Scholar
  41. 41.
    Cardenas-Gonzalez M, Osorio-Yanez C, Gaspar-Ramirez O, Pavkovic M, Ochoa-Martinez A, Lopez-Ventura D, et al. Environmental exposure to arsenic and chromium in children is associated with kidney injury molecule-1. Environ Res. 2016;150:653–62.CrossRefGoogle Scholar
  42. 42.
    Halatek T, Sinczuk-Walczak H, Janasik B, Trzcinka-Ochocka M, Winnicka R, Wasowicz W. Health effects and arsenic species in urine of copper smelter workers. J Environ Sci Health A Tox Hazard Subst Environ Eng. 2014;49(7):787–97.CrossRefGoogle Scholar
  43. 43.
    Hawkesworth S, Wagatsuma Y, Kippler M, Fulford AJ, Arifeen SE, Persson LA, et al. Early exposure to toxic metals has a limited effect on blood pressure or kidney function in later childhood, rural Bangladesh. Int J Epidemiol. 2013;42(1):176–85.CrossRefGoogle Scholar
  44. 44.
    Kim YD, Eom SY, Yim DH, Kim IS, Won HK, Park CH, et al. Environmental exposure to arsenic, lead, and cadmium in people living near Janghang copper smelter in Korea. J Korean Med Sci. 2016;31(4):489–96.CrossRefGoogle Scholar
  45. 45.
    Levine KE, Redmon JH, Elledge MF, Wanigasuriya KP, Smith K, Munoz B, et al. Quest to identify geochemical risk factors associated with chronic kidney disease of unknown etiology (CKDu) in an endemic region of Sri Lanka-a multimedia laboratory analysis of biological, food, and environmental samples. Environ Monit Assess. 2016;188(10):548.CrossRefGoogle Scholar
  46. 46.
    Peters BA, Hall MN, Liu X, Neugut YD, Pilsner JR, Levy D, et al. Creatinine, arsenic metabolism, and renal function in an arsenic-exposed population in Bangladesh. PLoS One. 2014;9(12):e113760.CrossRefGoogle Scholar
  47. 47.
    Rango T, Jeuland M, Manthrithilake H, McCornick P. Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka. Sci Total Environ. 2015;518–519:574–85.CrossRefGoogle Scholar
  48. 48.
    Tonelli M, Wiebe N, Bello A, Field CJ, Gill JS, Hemmelgarn BR, et al. Concentrations of trace elements in hemodialysis patients: a prospective cohort study. Am J Kidney Dis. 2017;70(5):696–704.CrossRefGoogle Scholar
  49. 49.
    Weidemann D, Kuo CC, Navas-Acien A, Abraham AG, Weaver V, Fadrowski J. Association of arsenic with kidney function in adolescents and young adults: results from the National Health and Nutrition Examination Survey 2009-2012. Environ Res. 2015;140:317–24.CrossRefGoogle Scholar
  50. 50.
    Bertke SJ, Lehman EJ, Wurzelbacher SJ, Hein MJ. Mortality of lead smelter workers: a follow-up study with exposure assessment. Am J Ind Med. 2016;59(11):979–86.CrossRefGoogle Scholar
  51. 51.
    Chen B, Lamberts LV, Behets GJ, Zhao T, Zhou M, Liu G, et al. Selenium, lead, and cadmium levels in renal failure patients in China. Biol Trace Elem Res. 2009;131(1):1–12.CrossRefGoogle Scholar
  52. 52.
    Pollack AZ, Mumford SL, Mendola P, Perkins NJ, Rotman Y, Wactawski-Wende J, et al. Kidney biomarkers associated with blood lead, mercury, and cadmium in premenopausal women: a prospective cohort study. J Toxicol Environ Health A. 2015;78(2):119–31.CrossRefGoogle Scholar
  53. 53.
    Sampson B, Curtis JR, Davies S. Survey of blood lead and plasma aluminium concentrations in patients of a renal unit. Nephrol Dial Transplant. 1989;4(5):375–81.CrossRefGoogle Scholar
  54. 54.
    Peters BA, Hall MN, Liu X, Slavkovich V, Ilievski V, Alam S, et al. Renal function is associated with indicators of arsenic methylation capacity in Bangladeshi adults. Environ Res. 2015;143(Pt A):123–30.CrossRefGoogle Scholar
  55. 55.
    Peters BA, Liu X, Hall MN, Ilievski V, Slavkovich V, Siddique AB, et al. Arsenic exposure, inflammation, and renal function in Bangladeshi adults: effect modification by plasma glutathione redox potential. Free Radic Biol Med. 2015;85:174–82.CrossRefGoogle Scholar
  56. 56.
    Akerstrom M, Sallsten G, Lundh T, Barregard L. Associations between urinary excretion of cadmium and proteins in a nonsmoking population: renal toxicity or normal physiology? Environ Health Perspect. 2013;121(2):187–91.CrossRefGoogle Scholar
  57. 57.
    Chaumont A, Nickmilder M, Dumont X, Lundh T, Skerfving S, Bernard A. Associations between proteins and heavy metals in urine at low environmental exposures: evidence of reverse causality. Toxicol Lett. 2012;210(3):345–52.CrossRefGoogle Scholar
  58. 58.
    Andra SS, Austin C, Arora M. The tooth exposome in children’s health research. Curr Opin Pediatr. 2016;28(2):221–7.CrossRefGoogle Scholar
  59. 59.
    Arora M, Austin C. Teeth as a biomarker of past chemical exposure. Curr Opin Pediatr. 2013;25(2):261–7.CrossRefGoogle Scholar
  60. 60.
    McMahon GM, Preis SR, Hwang SJ, Fox CS. Mid-adulthood risk factor profiles for CKD. J Am Soc Nephrol. 2014;25(11):2633–41.CrossRefGoogle Scholar
  61. 61.
    Parsa A, Kao WH, Xie D, Astor BC, Li M, Hsu CY, et al. APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med. 2013;369(23):2183–96.CrossRefGoogle Scholar
  62. 62.
    Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3).Google Scholar
  63. 63.
    Hughson MD, Douglas-Denton R, Bertram JF, Hoy WE. Hypertension, glomerular number, and birth weight in African Americans and white subjects in the southeastern United States. Kidney Int. 2006;69(4):671–8.CrossRefGoogle Scholar
  64. 64.
    Sanders AP, Svensson K, Gennings C, Burris HH, Oken E, Amarasiriwardena C, et al. Prenatal lead exposure modifies the effect of shorter gestation on increased blood pressure in children. Environ Int. 2018;120:464–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Emily C. Moody
    • 1
  • Steven G. Coca
    • 2
  • Alison P. Sanders
    • 1
    • 3
    Email author
  1. 1.Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of NephrologyIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Departments of Pediatrics & Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkUSA

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