Abstract: FR-PO1111
Relationship of Smoking and Kidney Diseases: Is Cadmium the Link?
Session Information
- Health Maintenance, Nutrition, and Metabolism
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Moore, Linda W., Houston Methodist, Houston, Texas, United States
- Frost, Adaani Ethel, Houston Methodist Academic Institute, Houston, Texas, United States
- Graviss, Edward A., Houston Methodist Academic Institute, Houston, Texas, United States
- Suki, Wadi N., Houston Methodist Academic Institute, Houston, Texas, United States
Background
Smoking and Cadmium has both been associated separately with occurrence and progression of kidney disease. Smoking is the main source of cadmium in US persons. This study attempts to determine the relative importance of smoking, vs. cadmium in the occurrence of kidney disease in a US population.
Methods
This is a cross-sectional study fron the National Health and Nutrition Examination Survery from 2003-2018. Participants were > 18 years of age, non pregnant, and had the following data: age, sex, serum and urine creatinine, smoking status, blood and urine cadmium levels. Smoking vs. non-smoking and cadmium toxicity (defined as a urine cadmium to creatinine ratio [CdCR] > 1 µg/g) and blood and urinary cadmium levels were analyzed and compared to estimated glomerular filtration rate (eGFR; CKD-Epi Consortium equation), urine albumin and creatinine and urine albumin to Creatinine ratio (UACR), serum bicarbonate, phorphorus and uric acid .
Results
From 80,308 individuals in NHANES 2003-2018, 12,945 met the primary inclusion criteria. Mean (SE) age was 47.3 (0.3) years and 68.3% were non-Hispanic White. A CdCR ≥1µg/g was detectable in 80% of the samples. In 15% of subjects with an eGFR>60ml/min/1.73m2, metabolic acidosis, hypophosphatemia, hypouricemia or microalbuminuria (suggestive of proximal tubular dysfunction) were present.
At any level of kidney function, smokers had a higher CdCR. The relationship between smoking and eGFR however was not significant. The relationship of CdCR to eGFR (as a continuous variable) was significant (r=0.165, b=-0.95; 95% CI= -1.186, -0.715; p<0.0001). As a categorical variable the odds for having a higher CdCR compared to the best eGFR group were greater in all eGFR groups <30, 30-44, 45-59, 60-74, 75-89, 90-105 (OR 1.16, 1.16, 1.17, 1.14, 1.13, and 1.13). In multiple regression analyses, the relation of smoking to kidney function was not significant. However, by multiple regression, urine CdCR was significantly associated with eGFR (p=0.0002); for every 1 unit increase in CdCR there was a 0.56 mL/min/1.73m2 decrease in eGFR.
Conclusion
Although smokers in this population were older with worse kidney function, urinary CdCR, and not smoking, was the only factor associated with worse kidney function by multivariable analysis.
Funding
- Private Foundation Support