Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-08T14:29:27.244Z Has data issue: false hasContentIssue false
  • English
  • Français

Safe levels of cadmium intake to prevent renal toxicity in human subjects

Published online by Cambridge University Press:  09 March 2007

Soisungwan Satarug ,
Melissa R. Haswell-Elkins  and
Michael R. Moore
Soisungwan Satarug*
Affiliation:
National Research Centre for Environmental Toxicology, The University of Queensland, 39 Kessels Road, Coopers Plains, Brisbane 4108, Queensland, Australia
Melissa R. Haswell-Elkins
Affiliation:
Indigenous Primary Health Program, The University of Queensland, 39 Kessels Road, Coopers Plains, Brisbane 4108, Queensland, Australia
Michael R. Moore
Affiliation:
National Research Centre for Environmental Toxicology, The University of Queensland, 39 Kessels Road, Coopers Plains, Brisbane 4108, Queensland, Australia
*
*Corresponding author: Dr Soisungwan Satarug, fax +61 7 3274 9003, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The present review attempts to provide an update of the scientific knowledge on the renal toxicity which occurs in human subjects as a result of chronic ingestion of low-level dietary Cd. It highlights important features of Cd toxicology and sources of uncertainty in the assessment of health risk due to dietary Cd. It also discusses potential mechanisms for increased susceptibility to Cd toxicity in individuals with diabetes. Exposure assessment on the basis of Cd levels in foodstuffs reveals that vegetables and cereals are the main sources of dietary Cd, although Cd is also found in meat, albeit to a lesser extent. Cd accumulates particularly in the kidney and liver, and hence offal contains relatively high amounts. Fish contains only small quantities of Cd, while crustaceans and molluscs may accumulate larger amounts from the aquatic environment. Data on Cd accumulation in human kidney and liver obtained from autopsy studies are presented, along with results of epidemiological studies showing the relationship between renal tubular dysfunction and kidney Cd burden. These findings suggest that a kidney Cd level of 50 μg/g wet weight is a maximum tolerable level in order to avoid abnormal kidney function. This renal Cd burden corresponds to a urinary Cd excretion of 2 μg/d. Accordingly, safe daily levels of Cd intake should be kept below 30 μg per person. Individual variations in Cd absorption and sensitivity to toxicity predicts that a dietary Cd intake of 30 μg/d may result in a slight renal dysfunction in about 1 % of the adult population. The previous guideline for a maximum recommended Cd intake of 1 μg/kg body weight per d is thus shown to be too high to ensure that renal dysfunction does not occur as a result of dietary Cd intake.

Keywords

Dietary cadmiumCadmium body burdenKidney toxicityZinc homeostasisDiabetic renal complications
Type
Review article
Information
British Journal of Nutrition , Volume 84 , Issue 6 , December 2000 , pp. 791 - 802
Copyright
Copyright © The Nutrition Society 2000

References

Australian New Zealand Food Authority (1998) The Australian Market Basket Survey 1996. Melbourne, NSW: Information Australia.Google Scholar
Bernard, A, Schdeck, C, Cardenas, A, Buchet, J-P & Lauwerys, R (1991) Potentiation of diabetic nephropathy in uniephrectomized rats subchronically exposed to cadmium. Toxicology Letters 58, 51–57.CrossRefGoogle Scholar
Borjesson, J, Bellander, T, Jarup, L, Elinder, CG & Mattsson, S (1997) In vivo analysis of cadmium in battery workers versus measurements of blood, urine, and workplace air. Occupational and Environmental Medicine 54, 424–431.CrossRefGoogle ScholarPubMed
Brand, IA & Heinickel, A (1991) Key enzymes of carbohydrate metabolism as targets of the 11.5-kDa Zn2+-binding protein (parathymosin). Journal of Biological Chemistry 266, 20984–20989.CrossRefGoogle Scholar
Brand, IA & Kleinekel, J (1996) Intracellular zinc movement and its effect on the carbohydrate metabolism of isolated rat hepatocytes. Journal of Biological Chemistry 271, 1941–1949.CrossRefGoogle ScholarPubMed
Bremner, I (1993) Involvement of metallothionein in the regulation of mineral metabolism. In Metallothionein III: Biological Roles and Medical Implication, pp. 111–124 [Suzuki, KT, Imura, N and Kimura, M, editors]. Basel, Switzerland: Kirkhauser Verlag.Google Scholar
Brozoska, MM & Moniuszko-Jakoniuk, J (1998) The influence of calcium content in diet on cumulation and toxicity of cadmium in the organism. Archives of Toxicology 72, 63–73.Google Scholar
Buchet, JP, Lauwerys, R, Roels, H, Bernard, A, Bruaux, P, Claeys, F, Ducoffre, G, Plaen, PD, Staessen, J, Amery, A, Lijnen, P, Thijs, L, Rondia, D, Sartor, F, Remy, AS & Nick, L (1990) Renal effects of cadmium body burden of the general population. Lancet 336, 699–702.CrossRefGoogle ScholarPubMed
Cai, S, Yue, L, Jin, T & Nordberg, G (1998) Renal dysfunction from cadmium contamination of irrigation water dose-response analysis in a Chinese population. Bulletin of the World Health Organization 76, 153–159.Google ScholarPubMed
Chan, HM, Zhu, L-F, Zhong, R, Grant, R, Goyer, RA & Cherian, MG (1993) Nephrotoxicity in rats following liver transplantation from cadmium-exposed rats. Toxicology and Applied Pharmacology 123, 89–96.CrossRefGoogle ScholarPubMed
Chaney, RL, Ryan, JA, Li, Y-M & Brown, SL (1999) Soil cadmium as a threat to human health. In Developments in Plant and Soil Sciences, vol. 85, pp. 219 [McLaughlin, MJ and Singh, BR, editors]. Dordrecht, The Netherlands: Kluwer Academic Publishers.Google Scholar
Chung, J, Nartey, NO & Cherian, MG (1986) Metallothionein levels in liver and kidney of Canadians – A potential indicator of environmental exposure to cadmium. Archives of Environmental Health 41, 319–323.CrossRefGoogle ScholarPubMed
Cousins, R (1994) Metal elements and gene expression. Annual Review of Nutrition 14, 449–469.CrossRefGoogle ScholarPubMed
Cunningham, JJ, Fu, A, Mearkle, PL & Brown, GR (1994) Hyperzincuria in individuals with insulin-dependent diabetes mellitus: concurrent zinc status and the effect of high-dose zinc supplementation. Metabolism 43, 1558–1562.CrossRefGoogle ScholarPubMed
Diamond, GL, Goodrum, PE, Felter, SP & Ruoff, WL (1997) Gastrointestinal absorption of metals. Drug and Chemical Toxicology 20, 345–368.CrossRefGoogle ScholarPubMed
Dight, I & Gladstone, W (1993) Pilot Study Final Report, Torres Strait Baseline Study. Cairns, Queensland: Great Barrier Reef Marine Park Authority.Google Scholar
Dorian, C, Gattone, VH & Klaassen, CD (1992) Renal cadmium deposition and injury as a result of accumulation of cadmium-metallothionein by the proximal convoluted tubules: a light microscopic autoradiography study with 109CdMT. Toxicology and Applied Pharmacology 114, 173–181.CrossRefGoogle ScholarPubMed
Dudley, RE, Gammal, LM & Klaassen, CD (1985) Cadmium-induced hepatic and renal injury in chronically exposed rats: Likely role of hepatic cadmium-metallothionein in nephrotoxicity. Toxicology and Applied Pharmacology 77, 414–426.CrossRefGoogle ScholarPubMed
Elinder, CG, Kjellstrom, T, Lind, B, Linnman, L, Piscator, M & Sundstedt, K (1983) Cadmium exposure from smoking cigarettes: variations with time and country where purchased. Environmental Research 32, 220–227.CrossRefGoogle ScholarPubMed
Elinder, CG, Kjellstrom, T, Lind, B, Molander, ML & Silander, T (1978) Cadmium concentrations in human liver, blood, and bile: comparison with a metabolic model. Environmental Research 17, 236–241.CrossRefGoogle ScholarPubMed
Elinder, CG, Lind, B, Kjellstrom, T, Linnman, L & Friberg, L (1976) Cadmium in kidney cortex, liver and pancreas from Swedish autopsies: Estimation of biological half time in kidney cortex, considering calorie intake and smoking habits. Archives of Environmental Health 31, 292–301.CrossRefGoogle ScholarPubMed
Ellis, KJ, Cohn, SH & Smith, TJ (1985) Cadmium inhalation exposure estimates: their significance with respect to kidney and liver burden. Journal of Toxicology and Environmental Health 15, 173–187.CrossRefGoogle Scholar
Ellis, KJ, Morgan, WD, Zanzi, I, Yasumura, S, Vartsky, D & Chon, SH (1981) Critical concentrations of cadmium in human renal cortex. Journal of Toxicology and Environmental Health 7, 691–703.CrossRefGoogle ScholarPubMed
Ellis, KJ, Yasumura, S, Vartsky, D & Cohn, SH (1983) Evaluation of biological indicators of body burden of cadmium in humans. Fundamental and Applied Toxicology 3, 169–174.CrossRefGoogle ScholarPubMed
Ellis, KJ, Yuen, K, Yasumura, S & Cohn, SH (1984) Dose-response analysis of cadmium in man: Body burden vs kidney dysfunction. Environmental Research 33, 216–226.CrossRefGoogle ScholarPubMed
Elsenhans, B, Kolb, K, Schumann, K & Forth, W (1992) Endogenous intestinal metallothionein possibly contributes to the renal accumulation of cadmium. IARC Scientific Publications 118, 225–230.Google Scholar
Elsenhans, B, Strugala, GJ & Schafer, SG (1997) Small-intestinal absorption of cadmium and the significance of mucosal metallothionein. Human and Experimental Toxicology 16, 429–434.CrossRefGoogle ScholarPubMed
Escobar, O, Sandoval, M, Vargas, A & Hempe, JM (1995) Role of metallothionein and cysteine-rich intestinal protein in the regulation of zinc absorption by the diabetic rat. Pediatrics Research 37, 321–327.CrossRefGoogle Scholar
Food and Agriculture Organization/World Health Organization (1998) Codex Alimentarius Commission. Discussion Paper on Cadmium, Joint FAO/WHO Food Standards Programme. Rane: FAO.Google Scholar
Flanagan, PR, McLellan, JS, Haist, J, Cherian, MG, Chamberlain, MJ & Valberg, LS (1978) Increased dietary cadmium absorption in mice and human subjects with iron deficiency. Gastroenterology 46, 609–623.Google Scholar
Fleet, JC (1998) Identification of Nramp2 as an iron transporter protein: another piece of the intestinal iron absorption puzzle. Nutrition Review 56, 88–89.CrossRefGoogle ScholarPubMed
Foulkes, EC (1993) The concept of critical levels of toxic heavy metals in target tissues. Critical Reviews in Toxicology 20, 327–339.CrossRefGoogle Scholar
Galal-Gorchev, H (1993) Dietary intake, levels in food and estimated intake of lead, cadmium and mercury. Food Additives and Contaminants 10, 115–128.CrossRefGoogle ScholarPubMed
Glynn, AW, Lind, Y, Funseth, E & Ilback, N-G (1998) The intestinal absorption of cadmium increase during a common viral infection (Coxsackie virus B3) in mice. Chemicobiological Interactions 113, 79–89.CrossRefGoogle ScholarPubMed
Gordon, AN, Pople, AR & Ng, J (1998) Trace metal concentrations in livers and kidneys of sea turtles from south-eastern Queensland, Australia. Marine and Freshwater Research 49, 409–414.Google Scholar
Groten, JP, Sinkeldam, EJ, Muys, T, Luten, JB & van Bladeren, PJ (1991) Interaction of dietary Ca, P, Mn, Cu, Fe, Zn and Se with accumulation and oral toxicity of cadmium in rats. Food Chemistry and Toxicology 29, 249–258.CrossRefGoogle Scholar
Gunshin, H, Mackenzie, B, Berger, UV, Gunshin, Y, Romero, MF, Boron, WF, Nussberger, S, Gollan, JL & Hediger, A (1997) Cloning and characterization of a mammalian proton-coupled metal-ion transporter. Nature 388, 482–488.CrossRefGoogle ScholarPubMed
Hanas, JS & Gunn, CG (1996) Inhibition of transcription factor IIIA-DNA interactions by xenobiotic metal ions. Nucleic Acids Research 24, 924–930.CrossRefGoogle ScholarPubMed
Hayano, M, Honda, R, Nogawa, K, Turitani, I, Kido, T & Kobayashi, E (1996) Dose-response relationship between urinary cadmium concentration and β2-microglobulin using logistic regression analysis. Archives of Environmental Health 51, 162–166.CrossRefGoogle Scholar
Hiratsuka, H, Satoh, S, Satoh, M, Nishijima, M, Katsuki, Y, Suzuki, J, Nakagawa, J, Sumiyoshi, M, Shibutani, M, Mitsumori, K, Tanaka-Kawagawa, T & Ando, M (1999) Tissue distribution of cadmium in rats given minimum amounts of cadmium-polluted rice or cadmium chloride for 8 months. Toxicology and Applied Pharmacology 160, 183–191.CrossRefGoogle ScholarPubMed
Hirsch, IB, Atchley, DH, Tsai, E, Labbe, RF & Chait, A (1998) Ascorbic acid clearance in diabetic nephropathy. Journal of Diabetes and its Complications 12, 259–263.CrossRefGoogle ScholarPubMed
International Programme in Chemical Safety (1992) Environmental Health Criteria. vol 134 Cadmium. Geneva: WHO.Google Scholar
Isbir, T, Tamer, L, Taylor, A & Isbir, M (1994) Zinc, copper and magnesium status in insulin-dependent diabetes. Diabetes Research 26, 41–45.Google ScholarPubMed
Iwata, K, Saito, H, Moriyama, M & Nakano, A (1992) Follow up study of renal tubular dysfunction and mortality among residents of an area polluted with cadmium. British Journal of Industrial Medicine 49, 736–737.Google ScholarPubMed
Jarup, L, Persson, B & Elinder, CG (1997) Blood cadmium as an indicator of dose in a long-term follow-up of workers previously exposed to cadmium. Scandinavian Journal of Work and Environmental Health 23, 31–36.CrossRefGoogle Scholar
Jarup, L, Berglund, M, Elinder, C, Nordberg, G & Vahter, M (1998) Health effects of cadmium exposure – a review of literature and a risk estimate. Scandinavian Journal of Work and Environmental Health 24 Suppl., 1–52.Google Scholar
Jin, T & Frankel, BJ (1996) Cadmium-metallothionein nephrotoxicity is increased in genetically diabetic as compared with normal Chinese hamsters. Pharmacology and Toxicology 79, 105–108.CrossRefGoogle ScholarPubMed
Jin, T, Lu, J & Nordberg, M (1998) Toxicokinetics and biochemistry of cadmium with special emphasis on the role of metallothionein. Neurotoxicology 19, 529–536.Google ScholarPubMed
Jin, T, Nordberg, GF, Sehlin, J, Leffler, P & Wu, J (1994) The susceptibility of spontaneously diabetic mice to cadmium-metallothionein nephrotoxicity. Toxicology 89, 81–90.CrossRefGoogle ScholarPubMed
Kagi, JHR (1993) Evolution, structure and chemical activity of class I metallothioneins: An overview. In Metallothionein III: Biological Roles and Medical Implication, pp. 29–56 [Suzuki, KT, Imura, N and Kimura, M, editors]. Basel, Switzerland: Kirkhauser Verlag.Google Scholar
Kuo, SM, Leaviti, PS & Lin, CP (1998) Dietary flavonoids interact with trace metals and affect metallothionein levels in human intestinal cells. Biological Trace Element Research 62, 135–153.CrossRefGoogle ScholarPubMed
Lauwerys, RR, Bernard, AM, Roels, HA & Buchet, JP (1994) Cadmium: Exposure markers as predictors of nephrotoxic effects. Clinical Chemistry 40/7, 1391–1394.CrossRefGoogle Scholar
Li, YM, Chaney, RL, Schneiter, AA & Miller, JF (1995) Genotypic variation in kernel cadmium concentration in sunflower germplasm under varying soil conditions. Crop Sciences 35, 137–141.CrossRefGoogle Scholar
Lin, J-L, Lu, F-H & Yeh, K-H (1995) Increased body cadmium burden in Chinese women without smoking and occupational exposure. Clinical Toxicology 33, 639–644.Google ScholarPubMed
Lind, Y, Engman, J, Jorhem, L & Glynm, AW (1998) Accumulation of cadmium from wheat bran, sugar-beet fibre, carrots and cadmium chloride in the liver and kidneys of mice. British Journal of Nutrition 80, 205–211.CrossRefGoogle ScholarPubMed
Liu, J, Habeecu, SS, Liu, Y & Klaassen, CD (1998) Acute cadmium injection is not a good model to study chronic Cd nephropathy: Comparison of chronic CdCl2 and CdMT exposure with acute CdMT injection in rats. Toxicology and Applied Pharmacology 153, 48–58.CrossRefGoogle Scholar
Lopez-Artiguez, M, Camean, A, Gonzalez, G & Repetto, M (1995) Metal accumulation in human kidney cortex: mutual interrelations and effect of human factors. Human and Experimental Toxicology 14, 335–340.CrossRefGoogle ScholarPubMed
Lupaz, MHS (1997) Diabetes nephropathy. Renal Disease 3, 679–688.Google Scholar
Lyon, TDB, Aughey, E, Scott, R & Fell, GS (1999) Cadmium concentrations in human kidney in the UK: 1978–1993. Journal of Environmental Monitor 1, 227–231.CrossRefGoogle ScholarPubMed
McKenzie, J, Kjellstrom, T & Sharma, P. (1986) Cadmium intake via oysters and health effects in New Zealand: cadmium intake, metabolism and effects in people with a high intake of oysters in New Zealand. Project summary: EPA/600/S1-86/004. Research Triangle Factor, NC: US Environmental Protection Agency.Google Scholar
McLaughlin, MJ & Singh, BR (editors) (1999) Cadmium in soils and plants. In Developments in Plant and Soil Sciences, vol. 85, pp. 1–7. Dordrecht, The Netherlands: Kluwer Academic Publishers.Google Scholar
Miller, GJ, Wylie, MJ & McKeown, D (1976) Cadmium exposure and renal accumulation in an Australian urban population. Medical Journal of Australia 1, 20–23.CrossRefGoogle Scholar
Mogensen, CE (1998) Preventing end-stage renal disease. Diabetic Medicine 15, Suppl. 4, S51–S56.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Moon, C-S, Zhang, Z-W, Shimbo, S, Watanabe, T, Moon, D-H, Lee, C-U, Lee, B-K, Ahn, K-D, Lee, S-H & Ikeda, M (1998) Evaluation of urinary cadmium and lead as markers of background exposure of middle-aged women in Korea. International Archives of Occupational and Environmental Health 71, 251–256.CrossRefGoogle ScholarPubMed
Moon, C-S, Zhang, Z-W, Shimbo, S, Watanabe, T, Moon, D-H, Lee, C-U, Lee, B-K, Ahn, K-D, Lee, S-H & Ikeda, M (1999) Evaluation of urinary cadmium and lead as markers of background exposure of middle-aged women in Korea: dietary intake as an influential factor. Toxicology Letters 108, 173–178.CrossRefGoogle ScholarPubMed
Morgan, H & Sherlock, JC (1984) Cadmium intake and cadmium in the human kidney. Food Additives Contaminants 1, 45–51.CrossRefGoogle ScholarPubMed
Muller, M, Anke, M, Illing-Gunther, H & Thiel, C (1998) Oral cadmium exposure of adults in Germany 2: Market basket calculations. Food Additives and Contaminants 15, 135–141.CrossRefGoogle ScholarPubMed
Nakagawa, H, Nishijo, M, Morikawa, Y, Tabata, M, Miura, K, Nishi, M, Kido, T & Nogawa, K (1996) Increased urinary β2-microglobulin and mortality rate by cause of death in a cadmium-polluted area. Environmental Health and Preventive Medicine 1, 144–148.CrossRefGoogle Scholar
Nakagawa, H, Nishijo, M, Morikawa, Y, Tabata, M, Senma, M, Kitagawa, Y, Kawano, S, Ishizaki, M, Sugita, N, Nishi, M, Kido, T & Nogawa, K (1993) Urinary β2-microglobulin and mortality in a cadmium polluted area. Archives of Environmental Health 48, 428–435.CrossRefGoogle Scholar
Nakashima, K, Kobayashi, E, Nogawa, K, Kido, T & Honda, R (1997) Concentration of cadmium in rice and urinary indicators of renal dysfunction. Occupational and Environmental Medicine 54, 750–755.CrossRefGoogle ScholarPubMed
Nagyova, A, Galbavy, S & Ginter, E (1994) Histopathological evidence of vitamin C protection against Cd-nephrotoxicity in guinea pigs. Experimental Toxicology and Pathology 46, 11–14.CrossRefGoogle ScholarPubMed
Nishijo, M, Nakagawa, H, Morikawa, M, Tabata, M, Miura, T, Yoshita, K, Higasgiguchi, K, Seto, T, Kido, T, Nogawa, K, Mizukoshi, K & Nishi, M (1999) Relationship between urinary cadmium and mortality among inhabitants living in a cadmium polluted area in Japan. Toxicology Letters 108, 321–327.CrossRefGoogle Scholar
Nordberg, GF, Jin, T, Kong, Q, Ye, T, Cai, S, Wang, Z, Zhuang, F & Wu, X (1997) Biological monitoring of cadmium exposure and renal effects in a population group residing in a polluted area in China. Science of Total Environment 199, 111–114.CrossRefGoogle Scholar
Orlowski, C, Piotrowski, JK, Subys, JK & Gross, A (1998) Urinary cadmium as indicator or renal cadmium in humans: as autopsy study. Human and Experimental Toxicology 17, 302–306.CrossRefGoogle ScholarPubMed
Palmiter, RD (1998) The elusive function of metallothioneins. Proceedings of the National Academy of Sciences USA 95, 8428–8430.CrossRefGoogle ScholarPubMed
Peters, AL, Davidson, MB, Schriger, DL & Hasselblad, V (1996) A clinical approach for the diagnosis of diabetes mellitus, an analysis using glycosylated hemoglobin levels. Journal of the American Medical Association 276, 1246–1252.CrossRefGoogle Scholar
Philcox, JC, Coyle, P, Michalska, A, Choo, KH & Rofe, AM (1995) Endotoxin-induced inflammation does not cause hepatic zinc accumulation in mice lacking metallothionein gene expression. Biochemical Journal 308, 543–546.CrossRefGoogle Scholar
Rayment, GE (1995) Sources of Cadmium in Agricultural Products. National Cadmium Workshop, DPIE/NFA, Canberra. Brisbane, Queensland: Queensland Department of Natural Resources.Google Scholar
Reeves, PG, Johnson, PE & Rossow, KL (1994) Absorption and organ content of cadmium from the kernels of confectionery sunflowers (Helianthus anmnis) fed to male rats. Journal of Agricultural and Food Chemistry 42, 2836–2843.CrossRefGoogle Scholar
Reeves, PG & Vanderpool, RA (1997) Cadmium burden of men and women who report regular consumption of confectionery sunflower kernels containing a natural abundance of cadmium. Environmental Health Perspectives 105, 1098–1104.CrossRefGoogle ScholarPubMed
Resource Sciences (1997) Managing Cadmium in Agriculture and Food. Canberra, Australia: Bureau of Resource Sciences.Google Scholar
Rimbach, G & Pallauf, J (1997) Cadmium accumulation, zinc status and mineral bioavailability of growing rats fed diets high in zinc with increasing amounts of phytic acid. Biological Trace Element Research 57, 59–70.CrossRefGoogle ScholarPubMed
Rofe, AM, Philcox, JC & Coyle, P (1996) Trace metal, acute phase and metabolic response to endotoxin in metallothionein-null mice. Biochemical Journal 314, 793–797.CrossRefGoogle ScholarPubMed
Satarug, S, Baker, JR, Reilly, PEB, Esumi, H & Moore, MR (2000) Evidence for a synergistic interaction between cadmium and endotoxin toxicity and for nitric oxide and cadmium displacement of metals in the kidney. Nitric Oxide: Biology and Chemistry 4, 431–440.CrossRefGoogle ScholarPubMed
Scheuhammer, AM (1988) The dose-dependent deposition of cadmium in organs of Japanese quails following oral administration. Toxicology and Applied Pharmacology 95, 153–161.CrossRefGoogle ScholarPubMed
Sheth, JJ (1999) Diabetes, microalbuminuria and hypertension. Clinical and Experimental Hypertension 21, 61–68.CrossRefGoogle ScholarPubMed
Spencer, JL, Silva, DT, Snelling, P & Hoy, WE (1998) An epidemic of renal failure among the Australian Aboriginals. Medical Journal of Australia 168, 537–541.CrossRefGoogle ScholarPubMed
Spickett, JT & Lazner, J (1979) Cadmium concentrations in human kidney and liver tissues from Western Australia. Bulletin of Environment and Contaminant Toxicology 23, 627–630.CrossRefGoogle ScholarPubMed
Staessen, JA, Buchet, JP, Ginucchio, G, Lauwerys, RR, Lijnen, P, Roels, H & Fagard, R (1996) Public health implications of environmental exposure to cadmium and lead: an overview of epidemiological studies in Belgium. Journal of Cardiovascular Risk 3, 26–41.CrossRefGoogle ScholarPubMed
Sudo, J, Hayashi, T, Terui, J, Soyama, M, Fukata, M & Katsukiko, K (1994) Kinetics of Cd2+ in plasma and kidneys after single intravenous injection of Cd-metallothionein-II. European Journal of Pharmacology 270, 229–235.Google ScholarPubMed
Sullivan, VK, Burnett, FR & Cousins, RJ (1998) Metallothionein expression is increased in monocytes and erythrocytes of young men during zinc supplementation. Journal of Nutrition 128, 707–713.CrossRefGoogle ScholarPubMed
Tandon, SK, Khandelwal, S, Jain, VK & Mathur, N (1993) Influence of dietary iron deficiency on acute metal intoxication. BioMetals 6, 133–138.CrossRefGoogle ScholarPubMed
Thijs, L, Staessen, J, Amery, A, Bruaux, P, Buchet, JP, Claeys, F, De-Plaen, P, Ducoffre, G, Lauwerys, R & Lijnen, P (1993) Determinants of serum zinc in a random population sample of four Belgian towns with different degrees of environmental exposure and body burden. Environmental Health Perspectives 98, 251–258.CrossRefGoogle Scholar
Tiran, E, Karpf, E & Tiran, A (1995) Age dependency of selenium and cadmium content in human liver, kidney and thyroid. Archives of Environmental Health 50, 242–246.CrossRefGoogle ScholarPubMed
Torra, M, To-Figueras, J, Rodamilans, M, Brunet, M & Corbella, J (1995) Cadmium and zinc relationships in the liver and kidney of humans exposed to environmental cadmium. Science of the Total Environment 170, 53–57.CrossRefGoogle ScholarPubMed
Vahter, M, Berglund, M, Nermell, B & Akesson, A (1996) Bioavailability of cadmium from shellfish and mixed diet in women. Toxicology and Applied Pharmacology 136, 332–341.CrossRefGoogle ScholarPubMed
Waalkes, MP, Coogan, TP & Barter, RA (1992) Toxicological principles of metal carcinogenesis with special emphasis on cadmium. Critical Reviews in Toxicology 22, 175–201.CrossRefGoogle ScholarPubMed
Wahba, ZZ & Waalkes, MO (1990) Cadmium-induced route specific alterations in essential trace element homeostasis. Toxicology Letters 54, 77–81.CrossRefGoogle ScholarPubMed
Walter, A, Rimbach, G, Most, E & Pallauf, J (1998) Effect of citric acid supplements to a maize-soya diet on the in vitro availability of minerals, trace elements and heavy metals. Journal of Veterinary Medicine 45, 517–524.CrossRefGoogle ScholarPubMed
Wang, X-P, Chan, HM, Goyer, RA & Cherian, MG (1993) Nephrotoxicity of repeated injection of cadmium-metallothionein in rats. Toxicology and Applied Pharmacology 119, 11–16.CrossRefGoogle ScholarPubMed
Watanabe, T, Nakatsuka, H, Seiji, K, Ioue, O, Cho, K-S, Lee, K-M, Lee, B-K, Lee, S-H & Ikeda, M (1989) Blood cadmium levels in the populations of Masan, Korea and in Miyagi, Japan: an inter-regional comparison. Toxicology Letters 47, 155–163.Google ScholarPubMed
Webb, J, Macey, DJ, Chua-Anusorn, W, Pierre, TG, Brooker, LR, Rahman, I & Noller, B (1999) Iron biominerals in medicine and the environment Coordination Chemistry Reviews 190–192, 1199–1215.CrossRefGoogle Scholar
Will, JC, Ford, ES & Bowman, BA (1999) Serum vitamin C concentrations and diabetes: findings from the Third National Health and Nutrition Examination. American Journal of Clinical Nutrition 70, 49–52.CrossRefGoogle ScholarPubMed
Williams, NR, Rajput-Williams, J, West, JD, Nigdikar, SV, Foote, JW & Howard, AN (1995) Plasma, granulocyte and mononuclear cell copper and zinc in patients with diabetes mellitus. Analyst 120, 887–890.CrossRefGoogle ScholarPubMed
Wing, AM (1993) The effect of whole wheat, wheat bran and zinc in the diet on the absorption and accumulation of cadmium in rats. British Journal of Nutrition 69, 199–209.CrossRefGoogle ScholarPubMed
Wolff, SP (1993) Diabetes mellitus and free radicals. Free radicals, transition metals and oxidative stress in the aetiology of diabetes and complications. British Medical Bulletin 49, 642–652.CrossRefGoogle Scholar
Wolnik, KA, Fricke, FL, Capar, SG, Braude, GL, Meyer, MW, Satzger, RD & Bonnin, E (1983) Elements in major raw agriculture crops in the United States. I. Cadmium and lead in lettuce, peanuts, potatoes, soybeans, sweet corns, and wheat. Journal of Agricultural and Food Chemistry 31, 1240–1244.CrossRefGoogle Scholar
Wood, RJ & Han, O (1998) Recently identified molecular aspects of intestinal iron absorption. Journal of Nutrition 128, 1841–1844.CrossRefGoogle ScholarPubMed
World Health Organization (1989) Evaluation of Certain Food Additives and Contaminants. Thirty-third Report of the Joint FAO/WHO Expert Committee on Food Additives. WHO Technical Report Series no: 776., pp. 28–31. Geneva: WHO.Google Scholar
World Health Organization (1992) Environmental Health Criteria. vol. 134. Cadmium. Geneva: WHO.Google Scholar
World Health Organization/Food and Agriculture Organization (1993) Toxicology Evaluation of Certain Food Additives and Contaminants. WHO Technical Report Series no: 837. Geneva: WHO.Google Scholar
Yamanaka, O, Kobayashi, E, Nogawa, K, Suwazono, Y, Sakurada, I & Kido, T (1998) Association between renal effects and cadmium exposure in cadmium-nonpolluted areas in Japan. Environmental Research 77A, 1–8.CrossRefGoogle Scholar
Yoshida, M, Ohta, H, Yamauchi, Y, Seki, Y, Sagi, M, Yamazaki, K & Sumi, Y (1998) Age-dependent changes in metallothionein levels in liver and kidney of the Japanese. Biological Trace Element Research 63, 167–175.CrossRefGoogle ScholarPubMed