genitourinary disorders
Heavy Metal Nephropathy
Cadmium nephropathy
Cadmium exposure due to contaminated water, food, or tobacco and, mainly, due to workplace exposures can cause nephropathy. It can also cause a glomerulopathy that is usually asymptomatic. Early manifestations of cadmium nephropathy are those of tubular dysfunction, including low molecular weight tubular proteinuria (eg, beta2-microglobulin), aminoaciduria, and renal glucosuria. Symptoms and signs, when they occur, are attributable to Chronic Kidney Disease . Renal disease follows a dose-response curve. Diagnosis of cadmium nephropathy is likely with the following: History of occupational exposure to cadmium Increased levels of urinary beta2-microglobulin (missed by urinary dipstick protein testing but detected using radioimmunoassay) Increased urinary cadmium levels (>7 mcg/g creatinine) Treatment is elimination of cadmium exposure; note that chelation with ethylenediaminetetraacetic acid (EDTA) may aggravate renal toxicity in acute cadmium poisoning but has been used successfully in cases of chronic cadmium exposure. Tubular proteinuria usually is irreversible. 