Kidney dysfunction and cadmium exposure--factors influencing dose-response relationships

Our early toxicological studies showed that metallothionein (MT) is a protein that carries cadmium (Cd) to the kidney, explaining why Cd exposures during long time periods may give rise to kidney dysfunction. This dysfunction is usually considered to be the critical effect, i.e. the adverse effect that occurs at the lowest exposure level. MT also provides intracellular protection against cadmium toxicity. In studies of population groups in cadmium contaminated areas in China, we investigated factors that affected the relationship between internal dose of Cd, as indicated by blood Cd (BCd) or urinary Cd (UCd), and the prevalence of kidney dysfunction. We found dose-response relationships between UCd and the prevalence of increased levels of biomarkers of renal tubular dysfunction (urinary beta-2-microglobulin, B2M, or N-acetyl-beta-d-glucosaminidase - NAG) or urinary albumin (UAlb), a biomarker of glomerular kidney dysfunction. Two years after Cd intake from contaminated rice was diminished, renal tubular dysfunction appeared unchanged or aggravated among those with higher UCd; Another 8 years later, i.e. 10 years after Cd intake was decreased, the prevalence of renal tubular dysfunction was still increased but UAlb had returned to normal. Factors that influenced the dose-response relationships were: (1) time after maximum exposure. (2) Concomitant exposure to other nephrotoxic agents such as inorganic arsenic. (3) Cd induced metallothionein mRNA levels in peripheral blood lymphocytes, used as a biomarker of the ability of each person, to synthesize MT. (4) The occurrence of increased levels in blood plasma of autoantibodies against MT. The two last points further support a role in humans of MT as a protective protein against tissue damage from cadmium and gives support to previous ideas developed partly in experimental systems.     

Cadmium biomonitoring and renal dysfunction among a population environmentally exposed to cadmium from smelting in China (ChinaCad)

Cadmium, an environmental pollutant, can have adverse effects on the human body. The kidney is the critical organ. In order to improve the understanding of the dose-response relationship between cadmium exposure and health effects, and especially renal dysfunction, a study on a general population group in China was performed. This study was therefore concerned with cadmium exposure biomarkers, such as the concentrations in blood (BCd) and urine (UCd), and effect biomarkers of renal dysfunction, such as ₂-microglobulin (₂m), retinol binding protein (RBP) and albumin (ALB). To improve the evaluation of exposure levels in relation to the adverse health effects of cadmium exposure in the general population, a quality control program was conducted to determine analytical quality in the determination of cadmium in blood and urine and for ₂m, creatinine, ALB and RBP. The measurements showed that analytical quality was adequate. The exposure and effect biomarkers were studied in the population groups living in three areas, namely a control area and two Cd polluted areas. In the highly exposed area, most of the BCd values were higher than 5 g/l and most of the UCd values were higher than 5 g/g creatinine. ₂-microglobulin, retinol binding protein, and albumin in urine were all significantly higher in the population living in the heavily polluted area than in that in the control area. Based on data from all three areas, a marked dose-response relationship between UCd or BCd and the prevalence of renal dysfunction was demonstrated. The number of abnormalities in kidney was related to the level of cadmium exposure. Only one index of renal tubular dysfunction was affected in subjects exposed to low levels of cadmium, but more than two indices of renal function were affected in those exposed to high levels.     

Association of lead and cadmium exposure with kidney stone incidence: A study on the non-occupational population in Nandan of China

BackgroundEnvironmental lead (Pb) and cadmium (Cd) pollution has been considered a risk factor in the etiology of kidney stones. However, the association between Pb and Cd exposure and kidney stone incidence has yet to be determined.ObjectivesThis study aimed to determine a possible the association between kidney stones with Pb and Cd exposure (alone or combined) in a non-occupational population.MethodsPb and Cd contaminations in soil-plant system were determined by flame atomic absorption spectrophotometry. Health risk assessment of dietary Pb or Cd intake from rice and vegetables were calculated. Kidney stones were diagnosed with urinary tract ultrasonography. Urinary cadmium (UCd) and blood lead (BPb) levels were determined by graphite-furnace atomic absorption spectrometry. Multivariate logistic regression models were constructed.ResultsThe hazard indexes (HI) of Pb and Cd were 7.91 and 7.31. The odds ratio (OR) was 2.83 (95 %CI:1.38−5.77) in males with high BPb (BPb ≥ 100 μg/L), compared with those with low BPb (BPb＜100 μg/L). Compared to those with low BPb and low UCd (BPb＜100 μg/L and UCd＜2 μg/g creatinine), the ORs were 2.58 (95 % CI:1.17−5.70) and 3.43 (95 % CI:1.21−9.16) in females and males with high BPb and high UCd (BPb ≥100 μg/L and UCd ≥2 μg/g creatinine), respectively. The OR was 3.16 (95 % CI:1.26−7.88) in males with high BPb and low UCd (BPb ≥ 100 μg/L and UCd ＜2 μg/g creatinine), compared to those with low BPb and low UCd.ConclusionsKidney stones incidence was increased by high Pb exposure in males, and by Pb and Cd co-exposure in males and females.     

Lack of reversal effect of EDTA treatment on cadmium induced renal dysfunction: a fourteen-year follow-up

The aim of this study was to evaluate the effect of ethylenediaminetetraacetic acid (EDTA) on cadmium (Cd) induced renal dysfunction. Seventeen workers (14 males, 3 females) were diagnosed with occupational Cd poisoning in 1986. These individuals had between 7 to 39 years of Cd exposure. From 1986 to 1999, patients received periodic EDTA therapy as part of their follow-up, all at the same hospital. Levels of urinary cadmium (UCd) and urinary beta2-microglobulin (B2M) were measured before and after each annual EDTA treatment period. Renal dysfunction was defined as urinary B2M > 0.8 mg/g Cr (creatinine). In these workers, patients with UCd level higher than 10 microg/g Cr in 1986 had abnormal B2M excretions (> or = 0.8 mg/g Cr) or trended to have abnormal B2M levels during the treatment period. However, in subjects with UCd concentration lower than 10 microg/g Cr in 1986, their urinary B2M excretions either remained normal (< 0.8 mg/g Cr) or returned to normal during the treatment period. The prevalence of renal dysfunction increased during the follow up period regardless of whether UCd levels increased or not, indicating a progressive renal dysfunction despite removal from Cd exposure. Our results suggest that reversibility of renal dysfunction caused by Cd related to the level of Cd exposure at the time of removal from exposure: renal dysfunction could be reversed if initial UCd < 10 microg/g Cr, but was irreversible when UCd > 10 microg/g Cr. Repeated examinations on these 17 Cd exposed workers from 1986 to 1999 also revealed that periodic administration of EDTA had no beneficial effects on chronic Cd-induced renal dysfunction.     

The Retention of Cadmium and Selenium Influence in Fowl and Chickens of F1 Generation

The retention of cadmium and selenium influence on Cd retention in the muscle, liver and kidneys of hens, chickens and in eggs was studied. Cadmium (Cd) as cadmium chloride (CdCl(2)) and selenium (Se) as sodium selenite (Na(2)SeO(3)) were added to feed at dosages: group 0-control, group 1-20 mg/kg Cd, group 2-30 mg/kg Cd + 4 mg/kg Se. The birds were exposed to Cd for 8 weeks. Cadmium level in hens and cocks was found highest in the kidneys, followed by the liver and muscle. Se supplementation resulted in Cd increase in the muscle tissue and in the reduction of Cd content in the liver and in significant decrease in the kidneys (p < 0.05). A higher Cd level in the yolk and lower in the white was noted in both experimental groups. Nonsignificant increase of Cd in eggs was noted in experimental groups with Se supplementation. Level of cadmium in organs of 7-day-old chicks hatched from Cd-treated hens in both experimental groups was low but the tendency to accumulate preferentially the Cd in the liver and kidneys was recorded. Supplementation of selenium in hens and cocks was not reflected in the decrease of Cd in these two organs of F(1) chickens but was reflected in increase in the muscle. In spite of relatively high Cd levels in the organs of layers no layer-egg-chickens transfer was observed. It was confirm that kidneys and liver are organs more attacked by dietary cadmium than muscle. Supplementation of low dose of Se resulted in decrease of cadmium deposition in analyzed organs.     

Association between blood cadmium level and bone mineral density reduction modified by renal function in young and middle-aged men

The association between cadmium exposure and bone mineral density (BMD) has not been well studied in young and middle-aged men. This study examined the relationship between the level of blood Cd (BCd) and BMD in a young to middle-aged representative male population while considering renal function. Using data from the 4th Korea National Health and Nutrition Examination Survey, 2008–2009, 1275 adult men aged 20–64 years were analyzed. BCd was measured by atomic absorption spectrophotometry and renal function was assessed by the estimated glomerular filtration rate (eGFR) with CKD-EPI formula. The risk of lower bone density was increased according to the increase in BCd levels after adjusting for eGFR and covariates, in which a significant interaction between BCd and eGFR existed. Significant negative associations between BCd and BMD were found: beta (p-value) were −0.03 (0.02), −0.04 (0.004) and −0.03 (0.04) in total femur, lumbar spine and femoral neck, respectively, which were limited to the people with eGFR ≤ lower 25%. Although, a causal relationship could not be determined because of a cross-sectional design in the present study, the results suggest low level Cd toxicity to bone via low eGFR and that measures to reduce environmental Cd exposure may be helpful to prevent bone loss in men.     

Effects of Cadmium on Bone Mineral Density in the Distal and Proximal Forearm: Two Female Population Studies in China

Long-term cadmium exposure may cause bone loss in distal or proximal sites in the forearm. In this study, we observed the effects of cadmium on bone mineral density in both distal and proximal sites in the forearm in two female populations. A total of 456 women living in two different areas participated. All of the participants completed a questionnaire, and the bone mineral density was measured in both the distal and proximal forearm by dual-energy X-ray absorptiometry. Urine samples were collected for the determination of urinary cadmium (UCd). UCd levels were significantly higher in the polluted group than the control group. The bone mineral density of the proximal forearm of subjects in polluted group or with high UCd levels was significantly lower than that of subjects in the control group or with low UCd levels. However, regarding bone mineral density of the distal forearm, this trend was only found in subjects living in area A. Our data showed that cortical bone mineral density in the forearm may be more strongly affected by cadmium exposure than trabecular bone mineral density.     

Prevalence of kidney dysfunction in humans – Relationship to cadmium dose, metallothionein, immunological and metabolic factors

Long term cadmium (Cd) exposure in occupational and general environments may give rise to kidney dysfunction. This effect is usually considered to be the critical effect, i. e. the effect that occurs at relatively low level of exposure. The present review focused on studies of the prevalence of cadmium-related kidney dysfunction among population groups residing in cadmium contaminated areas in China. Dose–response relationships were shown between UCd and the prevalence of increased levels of biomarkers in urine of renal tubular dysfunction such as urinary beta-2-microglobulin or N-acetyl-beta-d-glucosaminidase – NAG or urinary albumin, a biomarker of glomerular kidney dysfunction. Factors that influence these dose–response relationships include: 1) Metallothionein mRNA levels in peripheral blood lymphocytes, used as a biomarker of the ability of each person, to synthesize metallothionein (a protein known to provide intracellular protection against cadmium toxicity). 2) The occurrence of increased levels in blood plasma of autoantibodies against metallothionein. 3) Concomitant changes in glucose metabolism i e Type II diabetes. 4) Concomitant exposure to other nephrotoxic agents such as inorganic arsenic. Increased susceptibility in diabetics has been shown also in population groups in Europe. In persons with type II diabetes and increased levels of autoantibodies against metallothionein in blood plasma or in persons with concomitant exposure to environmental inorganic arsenic, indications of Cd-related kidney dysfunction was observed at UCd levels around 1 μg/g creatinine, levels found among “unexposed” population groups in many countries.     

High Cadmium Accumulation Among Humans and Primates: Comparison Across Various Mammalian Species—A Study from Japan

The majority of existing literature reports that cadmium (Cd) is toxic to humans and most living organisms. This paper reports the results of our study that measured Cd levels in the livers and kidneys of humans and other 50 mammalian species under normal conditions in Japan. The study tests the differences in the Cd concentrations across different mammalian species and sexes. Our results revealed that (1) there is a strong correlation between the Cd levels in the livers and kidneys across all examined species, (2) humans exhibit the highest Cd accumulation level in both organs, (3) primates also show a high Cd concentration at a level close to humans, (4) mice and rats show low Cd levels in both organs, indicating that humans accumulate about a few thousand times more Cd than mice and rats, and (5) the Cd concentration of female mammals is more than double of males for both organs. Our results indicate that these cross-sex as well as cross-species discrepancies cannot be explained by the difference in daily Cd intake. While further research is necessary to determine any potential role of Cd accumulation, we speculate that Cd plays some physiological function in the renal cortex of humans and primates.     

Blood pressure in relation to dietary calcium intake, alcohol consumption, blood lead, and blood cadmium in female nonsmokers

The interrelationship of dietary calcium (Ca) intake, alcohol consumption, blood lead (BPb), blood cadmium (BCd), age, and body mass index (BMI) to blood pressure was examined in 267 peasant women 40-85 years of age. They were residents of two rural areas in Croatia and differed with regard to dietary Ca intake: 100 women with low Ca intake (approximately 450 mg/day) and 167 women with relatively high Ca intake (approximately 940 mg/day). All of the women were nonsmokers and consumed very little or no alcohol. Median and range BPb values were 74 (29-251) microg/L in women with low Ca intake and 59 (21-263) microg/L in women with high Ca intake (p < 0.0002), whereas corresponding BCd values were 0.6 (0.2-3.6) microg/L and 0.6 (0.3-4.5) microg/L (p > 0.10). Results of multiple regression showed a significant (p < 0.05) increase in systolic blood pressure with age, BMI, and BCd, and marginally with alcohol consumption (multiple r = 0.48, p < 10(- 6)). An increase in diastolic blood pressure was significantly (p < 0.05) associated with BMI, age, and residence area (i.e., it was higher in women with low Ca intake), and marginally with BCd, and alcohol consumption (multiple r = 0.38, p < 10(-6)) When the two groups of women with different Ca intake were subdivided into consumers and nonconsumers of alcohol, BPb was related positively to alcohol consumption and inversely to Ca intake. The highest BPb was found in the subgroup of alcohol consumers with low Ca intake, and the lowest BPb in the subgroup of nonconsumers with high Ca intake: 78 (42-251) microg/L and 51 (22-192) microg/L, respectively (p < 10(-8)). Diastolic blood pressure was significantly higher in the former subgroup as compared to the latter: 95 (72-130) mm Hg and 90 (60-120) mm Hg, respectively (p < 0.05). This cannot be explained by age, BMI, or BCd, which were comparable in the two subgroups. The results indicate that alcohol consumption and low Ca intake can increase BPb, which may significantly contribute to an increase in diastolic blood pressure in female nonsmokers even at relatively low-level Pb exposure.     

Forage plants as an alternative feed resource for sustainable pig production in the tropics: a review

Globally, pressure on concentrate feed resources is increasing, especially in the tropics where many countries are net importers of food. Forage plants are a possible alternative, but their use as feed ingredients for pigs raises several issues related to their higher fibre and plant secondary metabolites contents as well as their lower nutritive value. In this paper, the nutritive value of several forage species and the parameters that influence this nutritive value in relationship to the plant family, the physiological stage, the plant part and the preservation method (fresh, hay and silage) are reviewed. The influence of the breed and the physiological status of the animal on animal voluntary intake of fibre-rich ingredients, digestibility as related to gastrointestinal volume and transit time and growth performances are also discussed. The final section highlights the advantages and drawbacks of forage plants in pig diets and stresses the need for proper economic evaluation to conclude on the benefits of the use of forage plants in pig feed.     

Environmental epidemiological study and estimation of benchmark dose for renal dysfunction in a cadmium-polluted area in China

We have performed a study aimed at investigating the critical concentration of urinary cadmium (UCd) required for the development of renal dysfunction. We studied population groups (totally 790 persons) living in two cadmium exposed areas and one control area in China. UCd, was determined as an indicator of cadmium exposure and accumulation, while the concentrations of N-acetyl-beta-D-glucosaminidase (NAG), its iso-form B (NAG-B), beta2-microglobulin (B2M), retinol binding protein (RBP), and albumin (ALB) in urine were measured as indicators of the renal effects caused by cadmium. There was a significantly increased prevalence of hyperNAGuria, hyperNAG-Buria, hyperB2Muria, hyperRBPuria and hyperALBuria with increasing levels of Cd excretion in urine. We used the benchmark dose (BMD) procedure to estimate the critical concentration of urinary cadmium in this general population. The lower confidence limit of the BMD (LBMD-05) of urinary cadmium for a 5% level of risk above the background level was estimated for each of the renal effect indicators. The BMD-05/LBMD-05 were estimated to be 4.46/3.99, 6.70/5.87, 8.36/7.31, 7.98/6.98 and 15.06/12.18 microg/g creatinine for urinary NAG-B, NAG, B2M, RBP and ALB, respectively. Our findings suggest, based on the present study, that the Lower Confidence Limit of the Population Critical Concentration of UCd (LPCCUCd-05) of tubular dysfunction for 5% excess risk level above the background may be ca. 3-4 microg/g creatinine, and that cadmium concentration in urine should be kept below this level to prevent renal tubular damage. This report is the first to use the BMD method in this field and to define the concept of critical concentration in urine.     

Environmental exposure and preventive measures in Sweden and EU*

Environmental exposure to cadmium (Cd) gives rise to renal tubular dysfunction at low cumulative doses of Cd. A possible role of Cd in influencing the occurrence of diseases, e.g., bone, reproductive and cancer in the general population groups environmentally exposed to Cd has been reported from Japan, Belgium, Sweden and China. Authorities have to pay attention to this fact and to act in order to prevent serious outcomes and personal suffering in the population groups at risk. A general approach in setting recommended health based limits and to regulate the occurrence of a substance existing in food stuff is to keep low levels -better to be on the safer side than on the risk side. In the case of cadmium it should be most clear that since cadmium has a very long biological half-life of 20 years in humans, increased cadmium exposure due to human activities can never be accepted. In cases where cadmium exposure can not be avoided the approach should be to limit and decrease exposure. Presently FAO/WHO Expert Committee on Food Additives and Food has a PTWI (provisional tolerable weekly intake) value for adult persons of 7 microg/kg body weight for Cd (WHO 2003) a value corresponding to 1 microg/kg body weight for each day of a week. For children and pregnant or lactating women daily intakes should not exceed 1 microg/kg body weight.     

Nramp5 expression and functionality likely explain higher cadmium uptake in rice than in wheat and maize

Plant and Soil - Cereals are the main dietary source of cadmium (Cd). Rice grains often contain higher levels of Cd than other cereals, but the reasons are unknown. The aims of this study were to...     

镉长期暴露对黑斑蛙的氧化胁迫和抗氧化能力的影响

在实验条件下,将黑斑蛙暴露于12．5mg／L和25．0mg／L浓度的镉溶液中30d,分别测定了黑斑蛙在暴露10、20和30d时肝、肾组织中镉（Cd）含量、过氧化产物丙二醛（MDA）的含量、还原型谷胱甘肽（GSH）含量和超氧化物歧化酶（SOD）活性,以探讨镉对机体的脂质过氧化作用及机体的抗氧化损伤机制。实验结果表明,不同剂量组黑斑蛙肝、肾镉含量、MDA含量均随着镉暴露时间的延长而升高,且肝MDA含量与镉在肝中的蓄积量呈显著正相关（R^2=0．8643,n=9）。肝脏GSH含量随镉暴露时间的延长而被显著诱导,且与MDA含量呈显著正相关（R^2=0．5933,n=9）;肾GSH含量则随暴露时间的延长而显著下降,与MDA含量呈显著负相关（R^2=0．8609,n=9）。不同剂量组肝SOD活性随镉暴露时间的延长而升高,肾SOD活性在高剂量组随镉暴露时间的延长表现为先升高后回落下降的趋势。可见,在镉的长期暴露下,细胞膜过氧化增强是镉伤害机体的主要原因,而GSH含量、SOD活性的升高则可能是机体抗过氧化的机理之一。     

Estimation of the reference level of urinary cadmium by using hybrid method in cadmium-polluted and non-polluted areas in China

This study investigated the reference level of urinary cadmium (UCd) of two Cd-polluted areas and one non-polluted area in China by applying the updated hybrid approach. Urinary N-acetyl-β-d-glucosaminidase (NAG) and β-2-microglobulin (β₂MG) were considered as indicators of early renal dysfunction. UCd was regarded as an indicator of the total internal Cd exposure. We recruited 3285 inhabitants for this investigation. Among them, 2106 were from polluted areas, while the other 1179 were from non-polluted areas. BMDL₁₀ (the lower 95% confidence limit of the benchmark dose (BMD)) of UCd for NAG was 1.55 μg/g creatine in men and 1.59 μg/g creatine in women. Using β₂MG as the renal effect marker, BMDL₁₀ of UCd was 1.58 μg/g and 1.53 μg/g in men and women, respectively. Our BMDL estimates accounting for age were lower than those reported in previous studies, suggesting that policies to control Cd exposure are warranted.     

Dietary Intake of Arsenic, Cadmium, Mercury, and Lead by the Population of Catalonia, Spain

The concentrations of arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) were determined in samples of food items widely consumed by the population of Catalonia, Spain. All samples were randomly acquired in 12 cities of Catalonia between March and June of 2006 and analyzed by inductively coupled plasma mass spectrometry. The dietary intake of these elements was estimated for various age–gender groups of population: children, adolescents, adults, and seniors. In order to determine the temporal trend on the dietary exposure to As, Cd, Hg, and Pb, the current results were compared with those of a previous survey (2000). In the present market basket study, for a standard male adult of 70-kg body weight living in Catalonia, the dietary intakes of As, Cd, Hg, and Pb were 261.01, 9.80, 12.61, and 45.13 μg/day, respectively, while in the 2000 survey, these intakes were 223.59, 15.73, 21.22, and 28.37 μg/day, for As, Cd, Hg, and Pb, respectively. For As, the only food groups currently contributing with measurable amounts to intake of total As were fish and shellfish and cereals, while for Cd the highest contribution to total intake corresponded to pulses, tubers, and cereals. For Hg, the contribution was only due to fish and shellfish, while cereals were the group with the highest contribution to total Pb intake. The estimated intakes of As, Cd, Hg, and Pb are notably lower than the respective provisional tolerable weekly intakes, which indicate that these intakes should not mean additional health risks for the consumers.     

Low ambient temperature decreases cadmium accumulation in the liver and kidneys of the bank vole (Clethrionomys glareolus)

The importance of photoperiod and ambient temperature on the accumulation of cadmium in the liver and kidneys of bank voles was determined in the present study. Males and females, aged 1 month, were given 3.0 g Cd ml^–1 drinking water and divided into four groups according to photoperiod (16 h light/8 h dark and 8 h light/16 h dark) and ambient temperature (20 or 5°C); liver and kidneys were removed for cadmium as well as copper, iron and zinc analyses at the end of 6 weeks. Bank voles exposed to 5°C in both photoperiods consumed approximately 30% less water containing cadmium than those kept at 20°C. However, the total accumulation of cadmium in the liver and kidneys of males and females exposed to the low temperatures was 4.3–4.8 and 2.2–3.3 times less than that in animals maintained at room temperature in the long and short photoperiod, respectively. Simultaneously, the low temperature brought about an increase in the copper concentrations in the liver (12–43%) and kidneys (47–78%), giving rise to an inverse correlation between the cadmium accumulation and the tissue copper concentration. In contrast to cadmium and copper, the concentrations of iron and zinc were affected primarily by photoperiod. These findings indicate that ambient temperature is an important determinant of cadmium retention in the bank vole. It appears that low temperature decreases tissue cadmium accumulation not only by reducing cadmium intake but also through changes in copper metabolism.     

Risk assessment on renal dysfunction caused by co-exposure to arsenic and cadmium using benchmark dose calculation in a Chinese population

Arsenic and cadmium are important inorganic toxicants in the environment. Humans certainly have the potential to be exposed to the mixtures of arsenic and cadmium, but the toxicological interactions of these inorganic mixtures are poorly defined. A general population co-exposed to arsenic and cadmium, was selected in China. The total number of participants was 245, made up of 122 in the arsenic-cadmium polluted area, 123 in the non polluted area. Urinary arsenic (UAs) and cadmium (UCd) were determined by atomic absorption spectrometry as exposure biomarkers and beta2-microglobulin (Ubeta2MG), albumin (UALB), N-acetyl-beta2-glucosaminidase (UNAG) in urine were determined as effect biomarkers. The benchmark dose (BMD) and the lower confidence limit on the benchmark dose (LBMD) were calculated to estimate the critical concentration of UAs and UCd. UAs and UCd concentrations in the polluted area were significantly higher than those in the non polluted area (P < 0.01). The levels of Ubeta2MG, UALB and UNAG in the polluted area were significantly higher than those in the non polluted area (P < 0.01). The BMD/LBMD of UAs and UCd for a 10% level of risk above the background level were estimated as 121.91/102.11 microg/g creatinine and 1.05/0.88 microg/g creatinine. It was suggested that the lower confidence limit of population critical concentration of UAs and UCd for renal dysfunction for 10% excess risk level above the background, which is obtained from LBMD, may need to be kept below 102 and 0.88 microg/g creatinine in order to prevent renal damage in general population co-exposed to arsenic and cadmium. It is indicated that combined effect of arsenic and cadmium were additive effect and/or synergistic effect, and cadmium may potentiate arsenic nephrotoxicity during the long-term and co-exposure to arsenic and cadmium in humans.