Cadmium Exposure and Chronic Kidney Disease in a Rural Population

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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.