Renal tubular function of workers exposed to low levels of cadmium.

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Abstract
Cadmium induced renal tubular effects were examined in 65 female workers in a factory manufacturing nickel cadmium batteries. Urinary .beta.2-microglobulin (.beta.2m), urinary N-acetyl-D-glucosaminidase activity (NAG), and serum creatinine and serum urea concentrations were used to assess the renal effects. Of the four measures, only urinary NAG and urinary .beta.2m showed a strong positive correlation with blood cadmium concentrations (r = 0.49 and 0.43 respectively); NAG showed a weaker correlation with urinary cadmium concentrations (r = 0.35). Urinary .beta.2m has weak correlation with urinary cadmium (r = 0.04). Only urinary NAG showed a significant deterioration in renal function among the exposed group. NAG detects the largest proportion of abnormalities among the exposed group. Abnormal urinary .beta.2m is detected in only 15.4% of the workers, half of whom have blood calcium above 10 .mu.g/l. The proportion of abnormalities detected by urinary NAG differs significantly from the proportion of abnormalities detected by urinary .beta.2m (p < 0.01). The age adjusted mean urinary NAG excretion showed a significant rise with urinary cadmium of above 3 .mu.g/g creatinine. Urinary .beta.2m failed to show any significant rise. With blood cadmium concentrations, the age adjusted mean urinary NAG excretion showed a rise from 1 .mu.g/l of blood cadmium followed by a plateau between blood cadmium concentrations of 3-10 .mu.g/l. No significant rise in mean urinary excretion in .beta.2m was seen until blood cadmium concentrations exceeded 10 .mu.g/l.

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