Association of cadmium environmental exposure with chronic kidney disease: A systematic review and meta-analysis.
CKD
Cadmium
Meta-analysis
Systematic review
Journal
The Science of the total environment
ISSN: 1879-1026
Titre abrégé: Sci Total Environ
Pays: Netherlands
ID NLM: 0330500
Informations de publication
Date de publication:
01 Jan 2024
01 Jan 2024
Historique:
received:
08
06
2023
revised:
14
09
2023
accepted:
15
09
2023
medline:
15
11
2023
pubmed:
28
9
2023
entrez:
27
9
2023
Statut:
ppublish
Résumé
Several observational studies investigated the relationship between environmental cadmium exposure and risk of chronic kidney disease (CKD). However, results from epidemiological studies are conflicting and wide variabilities have been reported. We conducted a meta-analysis to evaluate the relationship between environmental cadmium exposure and CKD risk, as assessed by decreased estimated Glomerular Filtration Rate (eGFR) in adults. PubMed, Embase and the Cochrane library databases were searched for studies published up to July 2023. A random-effects model using the restricted maximum likelihood (REML) method was used to calculate the overall estimate to assess the association between cadmium exposure and eGFR. Subgroup analysis, funnel plot, Egger's test, and the trim-and-fill method were also conducted. Thirty-one articles, 3 cohorts, 2 case-control and 26 cross-sectional studies, across 8 countries, involving 195.015 participants were included. The meta-analysis demonstrated an inverse association between high cadmium exposure and eGFR levels (standardized regression coefficient β = -0.09; 95 % CI = -0.15, -0.04). The subgroup analysis showed that the inverse association was significantly higher for blood cadmium exposure (β = -0.12; 95 % CI = -0.18, -0.06) than for urinary concentrations (β = -0.04; 95 % CI: -0.10, 0.03) or dietary exposure (β = -0.03; 95 % CI = -0.19, 0.14). Stratified analysis by different study design also showed an inverse association between cadmium exposure and eGFR, more evident in the cross-sectional studies (β = -0.11; 95 % CI = -0.18, -0.03) than in the cohort (β = -0.05; 95 % CI = -0.26, 0.17) and in the case-control studies (β = -0.05; 95 % CI = -0.32, 0.21). Our meta-analysis indicated that environmental cadmium exposure is associated with increased risk of CKD, as assessed by decreased eGFR, and this association is more evident for blood cadmium concentrations than for urinary concentrations or dietary exposure. Nevertheless, additional high quality prospective studies are needed to confirm the association between cadmium exposure and risk of CKD.
Sections du résumé
BACKGROUND
BACKGROUND
Several observational studies investigated the relationship between environmental cadmium exposure and risk of chronic kidney disease (CKD). However, results from epidemiological studies are conflicting and wide variabilities have been reported.
OBJECTIVES
OBJECTIVE
We conducted a meta-analysis to evaluate the relationship between environmental cadmium exposure and CKD risk, as assessed by decreased estimated Glomerular Filtration Rate (eGFR) in adults.
METHODS
METHODS
PubMed, Embase and the Cochrane library databases were searched for studies published up to July 2023. A random-effects model using the restricted maximum likelihood (REML) method was used to calculate the overall estimate to assess the association between cadmium exposure and eGFR. Subgroup analysis, funnel plot, Egger's test, and the trim-and-fill method were also conducted.
RESULTS
RESULTS
Thirty-one articles, 3 cohorts, 2 case-control and 26 cross-sectional studies, across 8 countries, involving 195.015 participants were included. The meta-analysis demonstrated an inverse association between high cadmium exposure and eGFR levels (standardized regression coefficient β = -0.09; 95 % CI = -0.15, -0.04). The subgroup analysis showed that the inverse association was significantly higher for blood cadmium exposure (β = -0.12; 95 % CI = -0.18, -0.06) than for urinary concentrations (β = -0.04; 95 % CI: -0.10, 0.03) or dietary exposure (β = -0.03; 95 % CI = -0.19, 0.14). Stratified analysis by different study design also showed an inverse association between cadmium exposure and eGFR, more evident in the cross-sectional studies (β = -0.11; 95 % CI = -0.18, -0.03) than in the cohort (β = -0.05; 95 % CI = -0.26, 0.17) and in the case-control studies (β = -0.05; 95 % CI = -0.32, 0.21).
DISCUSSION
CONCLUSIONS
Our meta-analysis indicated that environmental cadmium exposure is associated with increased risk of CKD, as assessed by decreased eGFR, and this association is more evident for blood cadmium concentrations than for urinary concentrations or dietary exposure. Nevertheless, additional high quality prospective studies are needed to confirm the association between cadmium exposure and risk of CKD.
Identifiants
pubmed: 37758140
pii: S0048-9697(23)05792-3
doi: 10.1016/j.scitotenv.2023.167165
pii:
doi:
Substances chimiques
Cadmium
00BH33GNGH
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
167165Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.