A retrospective cohort study was conducted to investigate the association between cadmium induced renal tubular dysfunction and mortality. A total of 230 subjects aged 40 or older and living in a cadmium polluted area in Kosaka Town, Akita Prefecture, Japan, were studied at least once between 1975 and 1977 and again in 1990. Urinary beta 2-microglobulin and total amino nitrogen concentrations were significantly related to mortality from all causes in women. The finding supports the idea that cadmium induced kidney damage is a factor associated with mortality in a general population exposed to environmental cadmium.