We thank Dr. Kawada for his interest in our manuscript entitled "Associations of low-level urine cadmium with kidney function in lead workers."[1] As discussed in the methods and shown in the footnotes to Tables 3 and 4 in the manuscript, we adjusted for blood and tibia lead. We have presented lead analyses in this cohort in multiple past publications[2-8] so, in order to focus on the unique cadmium associations and comply with space considerations, we did not show the lead regression coefficients. Multiple linear regression was used in the analysis.

References:

1 Weaver VM, Kim NS, Jaar BG et al. Associations of low-level urine cadmium with kidney function in lead workers. Occup Environ Med 2011;68:250-256. doi:oem.2010.056077 [pii] 10.1136/oem.2010.056077 [doi] [published Online First 2010/10/27].

2 Weaver VM, Lee BK, Ahn KD et al. Associations of lead biomarkers with renal function in Korean lead workers. Occup Environ Med 2003;60:551- 62. 2003/07/29].

3 Weaver VM, Schwartz BS, Ahn KD et al. Associations of renal function with polymorphisms in the delta-aminolevulinic acid dehydratase, vitamin D receptor, and nitric oxide synthase genes in Korean lead workers. Environ Health Perspect 2003;111:1613-9. 2003/10/07].

4 Weaver VM, Jaar BG, Schwartz BS et al. Associations among lead dose biomarkers, uric acid, and renal function in Korean lead workers. Environ Health Perspect 2005;113:36-42. 2005/01/01].

5 Weaver VM, Lee BK, Todd AC et al. Associations of patella lead and other lead biomarkers with renal function in lead workers. J Occup Environ Med 2005;47:235-43. doi:00043764-200503000-00005 [pii] [published Online First 2005/03/12].

6 Weaver VM, Schwartz BS, Jaar BG et al. Associations of uric acid with polymorphisms in the delta-aminolevulinic acid dehydratase, vitamin D receptor, and nitric oxide synthase genes in Korean lead workers. Environ Health Perspect 2005;113:1509-15. 2005/11/03].

7 Weaver VM, Lee BK, Todd AC et al. Effect modification by delta- aminolevulinic acid dehydratase, vitamin D receptor, and nitric oxide synthase gene polymorphisms on associations between patella lead and renal function in lead workers. Environ Res 2006;102:61-9. doi:S0013- 9351(06)00002-8 [pii] 10.1016/j.envres.2006.01.001 [doi] [published Online First 2006/02/21].

8 Weaver VM, Griswold M, Todd AC et al. Longitudinal associations between lead dose and renal function in lead workers. Environ Res 2009;109:101-7. doi:S0013-9351(08)00215-6 [pii] 10.1016/j.envres.2008.09.005 [doi] [published Online First 2008/11/29].

Conflict of Interest:

None declared