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)
Part of the following topical collections:
  1. Topical Collection on Metals and Health


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.


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.


Arsenic Cadmium Lead Chronic kidney disease Glomerular filtration rate 





Blood lead level


Body mass index


Blood pressure




estimated Glomerular Filtration Rate




Systolic blood pressure


Chronic kidney disease of unknown etiology


End-stage renal disease


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.


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

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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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