Cadmium exposure and end-stage renal disease
Cadmium exposure and end-stage renal disease
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DOI：
10.1053/ajkd.2001.28589
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发表时间：
2001-11-01
影响因子：
13.2
通讯作者：
Axelson, O
中科院分区：
文献类型：
--
作者：
Hellström, L;Elinder, CG;Axelson, O
镉的环境暴露可引起肾损伤和肾小管蛋白尿。我们调查了瑞典环境或职业暴露于镉的人群中低水平镉暴露与终末期肾病（ESRD）（肾脏替代治疗（RRT））之间的关系。根据以前或现在从事镉电池生产或居住在电池厂附近镉污染地区的所有人员的记录，我们将暴露定义为高（职业）、中度（住所距离工厂< 2公里）、低（住所距离工厂2至10公里）或无暴露（住所距离工厂> 10公里）。自1978年以来，所有接受RRT的个人都有全面的数据。RRT的年发病率从20 - 29岁年龄组的41/百万增加到70 - 79岁年龄组的243/百万，并且在优先定义的镉暴露人群中更高。调整年龄和性别后，镉暴露人群中RRT的Mantel-Haenszel率比（MH-RR）比未暴露人群高1.8（95%置信区间[CI]，1.3 - 2.3）;女性的MH-RR甚至更高（MH-RR，2.3; 95% CI，1.5 - 3.5）。RRT和镉暴露的直接年龄标准化率比从低暴露组的1.4（95%CI，0.8至2.0）分别增加到中度和高度暴露组的1.9（95%CI，1.3至2.5）和2.3（95%CI，0.6至6.0）。我们的结论是暴露于职业或相对较低的环境镉水平似乎是一个决定因素的发展终末期肾病。(C)2001年由国家肾脏基金会，公司。
Environmental exposure to cadmium may cause kidney damage and tubular proteinuria. We investigated the relationship between low-level cadmium exposure and end-stage renal disease (ESRD), indicated by renal replacement therapy (RRT), in a Swedish population environmentally or occupationally exposed to cadmium. Based on records of all persons in the population previously or presently employed in cadmium-battery production or residing in cadmium-polluted areas near the battery plants, we defined exposure as high (occupational), moderate (domicile < 2 km from a plant), low (domicile 2 to 10 km from a plant), or no exposure (domicile > 10 km from a plant). Comprehensive data were available for all individuals undergoing RRT since 1978. The annual incidence of RRT increased from 41 per million in the age group 20 to 29 years to 243 per million in the age group 70 to 79 years and was greater in a priori-defined populations with cadmium exposure. Adjusting for age and sex gave an increased Mantel-Haenszel rate ratio (MH-RR) of 1.8 (95% confidence interval [CI], 1.3 to 2.3) for RRT in the cadmium-exposed population compared with the unexposed group; the MH-RR was even higher for women (MH-RR, 2.3; 95% Cl, 1.5 to 3.5). Directly age-standardized rate ratios for RRT and cadmium exposure increased from 1.4 (95% Cl, 0.8 to 2.0) in the low-exposure group to 1.9 (95% Cl, 1.3 to 2.5) and 2.3 (95% Cl, 0.6 to 6.0) in the moderate- and high-exposure groups, respectively. We conclude that exposure to occupational or relatively low environmental levels of cadmium appears to be a determinant for the development of ESRD. (C) 2001 by the National Kidney Foundation, Inc.