2011
DOI: 10.1186/1476-069x-10-37
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Confounders in the assessment of the renal effects associated with low-level urinary cadmium: an analysis in industrial workers

Abstract: BackgroundAssociations of proteinuria with low-level urinary cadmium (Cd) are currently interpreted as the sign of renal dysfunction induced by Cd. Few studies have considered the possibility that these associations might be non causal and arise from confounding by factors influencing the renal excretion of Cd and proteins.MethodsWe examined 184 healthy male workers (mean age, 39.5 years) from a zinc smelter (n = 132) or a blanket factory (n = 52). We measured the concentrations of Cd in blood (B-Cd) and the u… Show more

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Cited by 49 publications
(35 citation statements)
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References 25 publications
(28 reference statements)
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“…In more recent studies conducted in the general population, urinary Cd levels below the accepted threshold of 2µg/g creatinine have been shown to be associated with kidney disease and albuminuria [25]. Haddam et al concluded that these associations could be due to influence of confounders such as diuresis, smoking or co-excretion with urinary proteins rather than direct effect of Cd [26]. The mean UCd concentration in CKDu patients and controls in our study is even below these threshold limits.…”
Section: Discussionmentioning
confidence: 44%
“…In more recent studies conducted in the general population, urinary Cd levels below the accepted threshold of 2µg/g creatinine have been shown to be associated with kidney disease and albuminuria [25]. Haddam et al concluded that these associations could be due to influence of confounders such as diuresis, smoking or co-excretion with urinary proteins rather than direct effect of Cd [26]. The mean UCd concentration in CKDu patients and controls in our study is even below these threshold limits.…”
Section: Discussionmentioning
confidence: 44%
“…The level of urinary retinol-binding protein (RBP) can be estimated as a significant index of renal tubular injury (Hu et al, 2012), which was used to evaluate the effect of Cd on renal function (Haddam et al, 2011). In the present study, we found a strong association between RBP and IQ.…”
Section: Discussionmentioning
confidence: 86%
“…However, few studies have assessed the effects of joint exposure to heavy metals on IQ or health (Bellinger, 2008a). Retinol binding protein (RBP) in urine is usually used to evaluate the effect of cadmium (Cd) on kidney function (Haddam et al, 2011). However, urinary RBP was found to be significantly associated with blood Pb (Bernard et al, 1995), which prompted us to measure RBP in order to probe the complex relationships among heavy metals.…”
Section: Introductionmentioning
confidence: 98%
“…It has been reported that one cigarette contains 1 to 2 μg of Cd [8]. According to the study of Haddam et al [9], the levels of Cd in urine were higher in current smokers than non smokers (1 vs 0.48 μg/gCr) among between Zinc smelter workers in Algeria. The increased excretion of urinary low molecular weight proteins such as β 2 -MG is most probably due to the renal toxicity of tobacco smoke.…”
Section: Resultsmentioning
confidence: 99%