CADMIUM-ASSOCIATED RENAL-DISEASE

Cadmium is widely used in industry, causing exposure of workers and en vironmental pollution because of its persistence in the biosystems. It s very long half-life in the human organism causes its accumulation ov er the lifetime in liver and kidneys. Cadmium ions have a high affinit y for tissue thiols, induce the synthesis of a carrier cysteine-rich p olypeptide called metallothionein, and impair proteoglycan metabolism. Significant renal effects include early tubular nephropathy manifeste d by proteinuria, amino aciduria, glucosuria, phosphaturia, and calciu m wastage. Chronic sequels include decrease in the glomerular filtrati on rate and increased risk of kidney stone disease. Biological monitor ing of cadmium absorption includes determination of urinaly cadmium an d of low molecular weight marker proteins, such as beta(2)-microglobul in or retinol binding protein, the tubular reabsorption of which is im paired before a frank proteinuria.