Nephrotoxic metals of cadmium, lead, mercury and arsenic and the odds of kidney stones in adults: An exposure-response analysis of NHANES 2007–2016

Highlights

• Blood cadmium levels were associated with increased odds of kidney stones.

• Total urinary arsenic levels were associated with increased odds of kidney stones.

• Dimethylarsinic acid levels were associated with increased odds of kidney stones.

• Current levels of lead and mercury are not of concerns in preventing kidney stones.

• Decreased odds were found with lower levels of blood lead and blood methyl mercury.

Abstract

Background

Nephrotoxic metals of arsenic, cadmium, lead and mercury exposures are common environmental pollutants. The associations between arsenic, cadmium, lead and mercury exposures and the risk of kidney stones are unclear.

Objective

To explore the associations between biomarkers of arsenic, cadmium, lead and mercury exposures and the odds of kidney stones.

Methods

Adult participants (≥20 years) from the 2007–2016 NHANES were included. Restricted cubic splines were adopted.

Results

The odds ratio (95% confidence interval) of kidney stones increased with increasing blood cadmium and reached the maximum at 1.00 μg/L [1.38 (1.02–1.88) overall, 1.62 (1.11–2.32) for women and 1.53 (1.06–2.22) for non-Hispanic white]. The odds of kidney stones increased with increasing urinary cadmium and reached the maximum at 1.50 μg/L [2.56 (1.17–5.59) overall, 5.57 (1.88–16.49) for women, 4.31 (1.75–10.63) for obese individuals and 3.75 (1.60–8.78) for non-Hispanic white]. The odds of kidney stones increased with increasing total urinary arsenic and urinary dimethylarsinic acid in women, and reached the maximum of 1.69 (1.08–2.67) at 40 μg/L and 1.71 (1.07–2.72) at 10.00 μg/L, respectively. Inverse associations were found between the odds of kidney stones and blood lead within 5.00 μg/dL [0.64 (0.46–0.90) overall, 0.53 (0.33–0.84) for men and 0.58 (0.37–0.92) for non-Hispanic white], methyl mercury within 3.00 μg/L [non-obese individuals: 0.71 (0.51–0.99)] and urinary arsenous acid within 1.20 μg/L [individuals other than non-Hispanic white: 0.63 (0.41–0.95)]. No association was found with other biomarkers.

Conclusions

Several biomarkers of arsenic, cadmium, lead and mercury exposures were associated with the odds of kidney stones in adults.