Risk assessment of nephrotoxicity of cadmium.

Cadmium as an environmental or occupational toxin has been well studied. Exposure can fairly easily be detected by analysis of cadmium in biological material. Different routes of cadmium uptake, such as via airborne particles, cigarette smoke or contaminated food, have been identified. Urinary concentrations associated with renal effects vary, depending on urinary marker of effect, and are as low as 2 micrograms cadmium/g creatinine. Different segments of the nephron are affected by cadmium. Urinary enzymes and serum derived proteins, mainly low-molecular weight proteins, as well as eicosanoids or glycosaminoglycans are among the tubular or glomerular markers of effect. Predisposing factors, such as smoking, dietary habits and low body iron stores have been described. It is concluded that even for low level cadmium exposure effects can be detected with sensitive diagnostic tools.