Objectives Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on early renal biomarkers.
Methods Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers i.e., microalbumin (µ-Alb), beta-2-microglobulin (β2-MG), retinol binding protein (RBP), N-acetyl-β-D-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. In order to explore the effect of Pb on the association between Cd and renal biomarkers (i.e., effect modification or interaction), we performed a multiple linear regression analysis (adjusting for age and pack-years of smoking) including an interaction term Pb x Cd.
Results The median Cd-B, Cd-U, Pb-B were: 0.8 µg/l (IQR = 0.5, 1.2), 0.5 µg/g creatinine (IQR = 0.3, 0.8) and 158.5 µg/l (IQR = 111.0, 219.3), respectively. The statistically significant interaction term Pb-B x Cd-B indicates that the impact of Cd-B on the enzymes NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., µ-Alb and β2-MG).
Conclusions Our findings indicate that Pb modifies (increases) the strength of the association between Cd and early renal biomarkers.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.