Cadmium Exposure and Chronic Kidney Disease in a Rural Population

摘要 慢性肾脏疾病是美国的一个主要公共卫生问题，其可导致终末期肾脏疾病。 疾病然而，已知的风险因素无法解释慢性肾脏病的所有变异性。 疾病风险，因此研究已扩展到检查环境因素，如金属， 风险的来源。早期流行病学和公认的机制证据表明，镉可能是 慢性肾病的一个重要危险因素。我们建议进行一项队列研究， 圣路易斯山谷累积镉暴露与慢性肾病之间的关系 糖尿病研究队列的纵向生理和行为数据。我们将估算累积的镉 使用历史采集的尿液样本对个体研究受试者的暴露量进行评估。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、家族史、糖尿病 糖尿病和相关的医学因素。拟议的研究将解决在理解 镉和慢性肾脏疾病的病因学，通过克服以前的几个方法学限制， 与暴露评估的精确度和研究设计相关的研究。如果研究表明 尿镉水平与慢性肾脏病之间的关系，有助于阐明其病理生理机制， 在预防方面，通过更广泛的监管来避免人口接触，因为主要来源是 接触镉是众所周知的。

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.