Cadmium Exposure and Chronic Kidney Disease in a Rural Population

摘要 慢性肾脏疾病在美国是一个主要的公共卫生问题，可能导致终末期肾病 疾病。然而，已知的危险因素并不能解释慢性肾脏的所有变异性。 疾病风险，因此研究已扩展到考察环境因素，如金属作为 风险来源。早期的流行病学和完善的机制证据表明，镉可能是 慢性肾脏疾病的重要危险因素。我们建议进行一项队列研究，调查 圣路易斯河谷累积镉暴露与慢性肾脏疾病的关系 糖尿病研究队列与纵向生理和行为数据。我们会估计累积的镉 使用历史上收集的尿样对个别研究对象的暴露。其他病理生理因素 将考虑包括临床信息、饮食、吸烟、体力活动、家族病史、糖尿病 糖尿病，以及促成医学因素。拟议的研究将解决对 镉与慢性肾脏疾病的病因学研究--克服以往研究方法的局限性 与暴露评估和研究设计的精密度相关的研究。如果研究表明两者之间存在关联 尿镉水平与慢性肾脏疾病之间的关系，有助于阐明其病理生理机制，有助于 在预防方面，导致更广泛的监管，以避免人口接触，因为主要来源是 对镉的暴露是公认的。

Abstract Chronic kidney disease is a major public health concern in the United States which can lead to end stage renal disease. However, known risk factors have been unable to account for all the variability in chronic kidney disease risk and therefore research has expanded into examining environmental factors such as metals as a source of risk. Early epidemiologic and well-established mechanistic evidence suggest that cadmium may be an important risk factor in chronic kidney disease. We propose to conduct a cohort study investigating the association between cumulative cadmium exposure and chronic kidney disease in the San Luis Valley Diabetes Study cohort with longitudinal physiologic and behavioral data. We will estimate cumulative cadmium exposure for individual study subjects using historically collected urine samples. Other pathophysiologic factors will be considered including clinical information, diet, smoking, physical activity, family history, diabetes mellitus, and contributing medical factors. The proposed study will address gaps in understanding of the etiology of cadmium and chronic kidney disease by overcoming several methodological limitations of previous studies related to precision of the exposure assessment and study design. If the study shows an association between urinary cadmium level and chronic kidney disease, it can help elucidate the pathophysiology and aid in prevention by leading to more extensive regulation to avoid population exposure since primary sources of exposure to cadmium are well recognized.