Incidence of nephrolithiasis in relation to environmental exposure to lead and cadmium in a population study

Azusa Hara, Wen Yi Yang, Thibault Petit, Zhen Yu Zhang, Yu Mei Gu, Fang Fei Wei, Lotte Jacobs, Augustine N. Odili, Lutgarde Thijs, Tim S. Nawrot, Jan A. Staessen

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Whether environmental exposure to nephrotoxic agents that potentially interfere with calcium homeostasis, such as lead and cadmium, contribute to the incidence of nephrolithiasis needs further clarification. We investigated the relation between nephrolithiasis incidence and environmental lead and cadmium exposure in a general population. In 1302 participants randomly recruited from a Flemish population (50.9% women; mean age, 47.9 years), we obtained baseline measurements (1985-2005) of blood lead (BPb), blood cadmium (BCd), 24-h urinary cadmium (UCd) and covariables. We monitored the incidence of kidney stones until October 6, 2014. We used Cox regression to calculate multivariable-adjusted hazard ratios for nephrolithiasis. At baseline, geometric mean BPb, BCd and UCd was 0.29. μmol/L, 9.0. nmol/L, and 8.5. nmol per 24 h, respectively. Over 11.5 years (median), nephrolithiasis occurred in 40 people. Contrasting the low and top tertiles of the distributions, the sex- and age-standardized rates of nephrolithiasis expressed as events per 1000 person-years were 0.68 vs. 3.36 (p=0.0016) for BPb, 1.80 vs. 3.28 (p=0.11) for BCd, and 1.65 vs. 2.95 (p=0.28) for UCd. In continuous analysis, with adjustments applied for sex, age, serum magnesium, and 24-h urinary volume and calcium, the hazard ratios expressing the risk associated with a doubling of the exposure biomarkers were 1.35 (p=0.015) for BPb, 1.13 (p=0.22) for BCd, and 1.23 (p=0.070) for UCd. In conclusion, our results suggest that environmental lead exposure is a risk factor for nephrolithiasis in the general population.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalEnvironmental Research
Publication statusPublished - 2016 Feb 1
Externally publishedYes


  • Cadmium
  • Lead
  • Nephrolithiasis
  • Population science
  • Risk stratification

ASJC Scopus subject areas

  • Biochemistry
  • Environmental Science(all)


Dive into the research topics of 'Incidence of nephrolithiasis in relation to environmental exposure to lead and cadmium in a population study'. Together they form a unique fingerprint.

Cite this