SYSTEMATIC REVIEW article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1555028
This article is part of the Research TopicToxicity Mechanisms, Exposure, Toxicokinetic and Risk Assessment Aspects of Metals, Toxic for Animals and Humans, Volume IIIView all 12 articles
Environmental cadmium exposure and risk of kidney stones: systematic review and dose-response meta-analysis
Provisionally accepted
- 1Department of Urology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- 2Department of Radiology，Chongqing Hospital of Traditional Chinese Medicine，Chongqing，China., Chongqing, China
- 3Department of Urology, Shenzhen University General Hospital, Shenzhen, China., Shenzhen, China
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Background: Growing evidence have investigated relationship between cadmium exposure and kidney stones. Nevertheless, the results remain controversial. Therefore, we performed a comprehensive systematic review and meta-analysis based on updated evidence to address these gaps.: Medline, EMBASE and Web of Science were searched to identify current evidence up to July 31, 2024. Characteristics and outcomes of the included studies were extracted based on the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. The random effects model was used to determine the association between cadmium exposure and kidney stones risk. Results: Seventeen studies involving 159, 011 individuals were included in the meta-analysis. Comparing highest-versus-lowest cadmium exposure levels, summary relative risks (RRs) for kidney stones were [relative risk (RR) 1.19, 95% confidence interval (CI) 1.10 to 1.29].Subgroup analysis showed that urinary (RR = 1.19; 95%CI: 1.08 to 1.30) and blood (RR = 1.49; 95% CI: 1.10 to 2.02) levels of cadmium were associated with an increased risk of kidney stones. By contrast to non-cadmium contaminated area, blood (RR = 1.08; 95% CI: 1.00 to 1.15) and urinary (RR = 1.16; 95% CI: 1.05 to 1.27) levels of cadmium were associated with an increased risk of kidney stones in cadmium contaminated area. In the dose-response meta-analysis, we observed a consistent linear positive association between cadmium exposure and kidney stones risk, the summary RR for each 1.0 µg/L of cadmium increase in urine was 1.07 (95% CI 1.01 to 1.13).Our findings suggest that cadmium exposure is associated with kidney stones risk. These findings reinforce the importance of environmental cadmium exposure in kidney stones risk, beyond the roles of conventional risk factors. Efforts to reduce population exposures to cadmium might help to reduce the personal, financial, and societal burden of kidney stones.
Keywords: Kidney Stones, Cadmium exposure, Heavy metal；Systematic, heavy metal, Systematic review
Received: 03 Jan 2025; Accepted: 10 Jul 2025.
Copyright: © 2025 Ren, Ren, Tang, Li, Lu, Lin, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Feng Wang, Department of Urology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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