Urinary trehalase activity as an indicator of kidney injury due to environmental cadmium exposure

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Abstract
One hundred and seventy-eight subjects, patients with Itai-itai disease and their family members, aged 12–87 years living in a cadmium (Cd)-polluted area in the Jinzu River basin (Cd-exposed group) and 176 controls (control group) were examined. In the Cd-exposed group urinary trehalase increased with increasing age, urinary β2-microglobulin (β2-m) and retinol-binding protein. Although urinary cadmium was higher in the Cd-exposed group, no particular correlation was found between urinary trehalase and urinary cadmium. Seventeen men and 11 women showed raised urinary trehalase activities despite normal values of urinary β2-m (<300 μg/g.creatinine), suggesting that urinary trehalase increases earlier than urinary β2-m. In 19 patients with Itai-itai disease included in the Cd-exposed group, urinary trehalase decreased with decreasing reciprocal of serum creatinine, suggesting that urinary trehalase decreases in the most advanced cases of chronic cadmium nephropathy due to reduced tubular cell mass.