Tsai Kai-Fan, Hsu Pai-Chin, Kung Chia-Te, Lee Chien-Te, You Huey-Ling, Huang Wan-Ting, Li Shau-Hsuan, Cheng Fu-Jen, Wang Chin-Chou, Lee Wen-Chin
Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Int J Environ Res Public Health. 2021 Nov 24;18(23):12337. doi: 10.3390/ijerph182312337.
Low-level cadmium exposure has adverse effects on chronic kidney disease (CKD); however, the risk factors for elevated blood cadmium levels (BCLs) have not been studied in CKD. We conducted a cross-sectional investigation in 200 CKD patients and stratified them by the tertiles of BCL to compare their demographic, environmental, and biochemical data. The factors associated with BCL were identified, and their effects were examined in subgroups. In the analyses, female sex, smoking, and CKD stage 5D were associated with high BCL, and statin was inversely correlated with BCL (odds ratio [95% confidence interval, CI], 6.858 [2.381-19.746], < 0.001, 11.719 [2.843-48.296], = 0.001, 30.333 [2.252-408.520], = 0.010, and 0.326 [0.122-0.873], = 0.026; deviations of BCL [nmol/L, 95% CI], 2.66 [1.33-4.00], < 0.001, 3.68 [1.81-5.56], < 0.001, 3.38 [0.95-5.82], = 0.007, and -2.07 [-3.35--0.78], = 0.002). These factors were also independently correlated with BCL in subgroups, including non-dialysis CKD, hypertensive patients, non-smokers, and male patients. In conclusion, female sex, smoking, and CKD stage 5D were the major risk factors for elevated BCL; additionally, statins were negatively associated with BCL in CKD.
低水平镉暴露对慢性肾脏病(CKD)有不良影响;然而,尚未对CKD患者血镉水平(BCL)升高的危险因素进行研究。我们对200例CKD患者进行了横断面调查,并根据BCL三分位数对他们进行分层,以比较其人口统计学、环境和生化数据。确定了与BCL相关的因素,并在亚组中检查了它们的影响。分析结果显示,女性、吸烟和CKD 5D期与高BCL相关,而他汀类药物与BCL呈负相关(比值比[95%置信区间,CI]分别为6.858[2.381 - 19.746],P < 0.001;11.719[2.843 - 48.296],P = 0.001;30.333[2.252 - 408.520],P = 0.010;以及0.326[0.122 - 0.873],P = 0.026;BCL的偏差[nmol/L,95%CI]分别为2.66[1.33 - 4.00],P < 0.001;3.68[1.81 - 5.56],P < 0.001;3.38[0.95 - 5.82],P = 0.007;以及 - 2.07[-3.35 - - 0.78],P = 0.002)。这些因素在包括非透析CKD、高血压患者、非吸烟者和男性患者在内的亚组中也与BCL独立相关。总之,女性、吸烟和CKD 5D期是BCL升高的主要危险因素;此外,他汀类药物在CKD中与BCL呈负相关。