{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:45:48Z","timestamp":1791913548282,"version":"4.3.4"},"reference-count":58,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011892","name":"Kaohsiung Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG8K1321"],"award-info":[{"award-number":["CMRPG8K1321"]}],"id":[{"id":"10.13039\/501100011892","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Low-level cadmium exposure has adverse effects on chronic kidney disease (CKD); however, the risk factors for elevated blood cadmium levels (BCLs) have not been studied in CKD. We conducted a cross-sectional investigation in 200 CKD patients and stratified them by the tertiles of BCL to compare their demographic, environmental, and biochemical data. The factors associated with BCL were identified, and their effects were examined in subgroups. In the analyses, female sex, smoking, and CKD stage 5D were associated with high BCL, and statin was inversely correlated with BCL (odds ratio [95% confidence interval, CI], 6.858 [2.381\u201319.746], p &lt; 0.001, 11.719 [2.843\u201348.296], p = 0.001, 30.333 [2.252\u2013408.520], p = 0.010, and 0.326 [0.122\u20130.873], p = 0.026; deviations of BCL [nmol\/L, 95% CI], 2.66 [1.33\u20134.00], p &lt; 0.001, 3.68 [1.81\u20135.56], p &lt; 0.001, 3.38 [0.95\u20135.82], p = 0.007, and \u22122.07 [\u22123.35\u2013\u22120.78], p = 0.002). These factors were also independently correlated with BCL in subgroups, including non-dialysis CKD, hypertensive patients, non-smokers, and male patients. In conclusion, female sex, smoking, and CKD stage 5D were the major risk factors for elevated BCL; additionally, statins were negatively associated with BCL in CKD.<\/jats:p>","DOI":"10.3390\/ijerph182312337","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T05:23:02Z","timestamp":1638163382000},"page":"12337","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The Risk Factors of Blood Cadmium Elevation in Chronic Kidney Disease"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-3302","authenticated-orcid":false,"given":"Kai-Fan","family":"Tsai","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pai-Chin","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Te","family":"Kung","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4704-1956","authenticated-orcid":false,"given":"Chien-Te","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huey-Ling","family":"You","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Ting","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shau-Hsuan","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Jen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-751X","authenticated-orcid":false,"given":"Chin-Chou","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6172-1483","authenticated-orcid":false,"given":"Wen-Chin","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Genchi, G., Sinicropi, M.S., Lauria, G., Carocci, A., and Catalano, A. (2020). The Effects of Cadmium Toxicity. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17113782"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Chen, H.L., Fang, J.C., Chang, C.J., Wu, T.F., Wang, I.K., Fu, J.F., Huang, Y.C., Yen, J.S., Weng, C.H., and Yen, T.H. (2021). Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients. Healthcare, 9.","DOI":"10.3390\/healthcare9040413"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/10773525.2018.1518745","article-title":"Impact of occupational cadmium exposure on bone in sewage workers","volume":"24","author":"Taha","year":"2018","journal-title":"Int. J. Occup. Environ. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e015694","DOI":"10.1136\/bmjopen-2016-015694","article-title":"Causes of death in patients with Itai-itai disease suffering from severe chronic cadmium poisoning: A nested case-control analysis of a follow-up study in Japan","volume":"7","author":"Nishijo","year":"2017","journal-title":"BMJ Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1159\/000452576","article-title":"Cadmium Exposure is Associated with the Prevalence of Dyslipidemia","volume":"40","author":"Zhou","year":"2016","journal-title":"Cell Physiol. Biochem."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"10748","DOI":"10.1007\/s11356-019-07249-6","article-title":"Associations between urinary cadmium levels, blood pressure, and hypertension: The ESTEBAN survey","volume":"27","author":"Gabet","year":"2020","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.envres.2014.04.008","article-title":"Blood cadmium levels are associated with a decline in lung function in males","volume":"132","author":"Oh","year":"2014","journal-title":"Environ. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1080\/15287394.2012.670895","article-title":"Cadmium risk assessment in relation to background risk of chronic kidney disease","volume":"75","author":"Ginsberg","year":"2012","journal-title":"J. Toxicol. Environ. Health A"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1093\/bmb\/ldg032","article-title":"Hazards of heavy metal contamination","volume":"68","year":"2003","journal-title":"Br. Med. Bull."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0378-4274(02)00381-8","article-title":"A global perspective on cadmium pollution and toxicity in non-occupationally exposed population","volume":"137","author":"Satarug","year":"2003","journal-title":"Toxicol. Lett."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/jat.3129","article-title":"Metals in cosmetics: Implications for human health","volume":"35","author":"Borowska","year":"2015","journal-title":"J. Appl. Toxicol."},{"key":"ref_12","first-page":"1409","article-title":"Blood mercury, lead and cadmium levels and determinants of exposure among newcomer South and East Asian women of reproductive age living in Vancouver, Canada","volume":"619\u2013620","author":"Kosatsky","year":"2018","journal-title":"Sci. Total. Environ."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.jtemb.2014.02.003","article-title":"Gender difference in blood cadmium concentration in the general population: Can it be explained by iron deficiency?","volume":"28","author":"Kim","year":"2014","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"267","DOI":"10.11622\/smedj.2016082","article-title":"Do people from Taiwan have higher heavy metal levels than those from Western countries?","volume":"58","author":"Liu","year":"2017","journal-title":"Singap. Med. J."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hill, N.R., Fatoba, S.T., Oke, J.L., Hirst, J.A., O\u2019Callaghan, C.A., Lasserson, D.S., and Hobbs, F.D. (2016). Global Prevalence of Chronic Kidney Disease\u2014A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158765"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"272","DOI":"10.3346\/jkms.2015.30.3.272","article-title":"Environmental heavy metal exposure and chronic kidney disease in the general population","volume":"30","author":"Kim","year":"2015","journal-title":"J. Korean Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1093\/aje\/kwp248","article-title":"Blood cadmium and lead and chronic kidney disease in US adults: A joint analysis","volume":"170","author":"Guallar","year":"2009","journal-title":"Am. J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1159\/000491708","article-title":"Incidence, Prevalence, and Duration of Chronic Kidney Disease in Taiwan: Results from a Community-Based Screening Program of 106,094 Individuals","volume":"140","author":"Tsai","year":"2018","journal-title":"Nephron"},{"key":"ref_19","unstructured":"Taiwan Society of Nephrology (2020). Kidney Disease in Taiwan 2020 Annual Report, National Institutes of Health & Taiwan Society of Nephrology."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Tsai, H.J., Hung, C.H., Wang, C.W., Tu, H.P., Li, C.H., Tsai, C.C., Lin, W.Y., Chen, S.C., and Kuo, C.H. (2021). Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020282"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.jhazmat.2019.04.082","article-title":"The association between plasma selenium and chronic kidney disease related to lead, cadmium and arsenic exposure in a Taiwanese population","volume":"375","author":"Wu","year":"2019","journal-title":"J. Hazard. Mater."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1093\/ndt\/gfq448","article-title":"Blood cadmium level\u2019s association with 18-month mortality in diabetic patients with maintenance haemodialysis","volume":"26","author":"Yen","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e3717","DOI":"10.1097\/MD.0000000000003717","article-title":"Association Between Blood Cadmium Levels and Mortality in Peritoneal Dialysis","volume":"95","author":"Lee","year":"2016","journal-title":"Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"825","DOI":"10.7326\/0003-4819-158-11-201306040-00007","article-title":"Evaluation and management of chronic kidney disease: Synopsis of the kidney disease: Improving global outcomes 2012 clinical practice guideline","volume":"158","author":"Stevens","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group","volume":"130","author":"Levey","year":"1999","journal-title":"Ann. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1159\/000085422","article-title":"Water treatment for hemodialysis: A 2005 update","volume":"149","author":"Cappelli","year":"2005","journal-title":"Contrib. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jhazmat.2009.04.090","article-title":"The inhibition effect of 2,3,7,8-tetrachlorinated dibenzo-p-dioxin-induced aryl hydrocarbon receptor activation in human hepatoma cells with the treatment of cadmium chloride","volume":"170","author":"Chao","year":"2009","journal-title":"J. Hazard. Mater."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.envres.2018.11.009","article-title":"Associations between blood cadmium concentration and kidney function in the U.S. population: Impact of sex, diabetes and hypertension","volume":"169","author":"Madrigal","year":"2019","journal-title":"Environ. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"34427","DOI":"10.1007\/s11356-021-13209-w","article-title":"Elevated cadmium and 8-hydroxy-2\u2019-deoxyguanosine (8-OHdG) levels in residents living near electroplating industries","volume":"28","author":"Xu","year":"2021","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.envres.2010.02.007","article-title":"Blood cadmium levels in women of childbearing age vary by race\/ethnicity","volume":"110","author":"Mijal","year":"2010","journal-title":"Environ. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.envres.2006.08.003","article-title":"Gender differences in the disposition and toxicity of metals","volume":"104","author":"Vahter","year":"2007","journal-title":"Environ. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"284","DOI":"10.2105\/AJPH.92.2.284","article-title":"Cadmium exposure in pregnancy and lactation in relation to iron status","volume":"92","author":"Akesson","year":"2002","journal-title":"Am. J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"F705","DOI":"10.1152\/ajprenal.00198.2007","article-title":"Knockdown of endosomal\/lysosomal divalent metal transporter 1 by RNA interference prevents cadmium-metallothionein-1 cytotoxicity in renal proximal tubule cells","volume":"293","author":"Abouhamed","year":"2007","journal-title":"Am. J. Physiol. Renal. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1097\/HJH.0b013e3283581a64","article-title":"Effect of iron restriction on renal damage and mineralocorticoid receptor signaling in a rat model of chronic kidney disease","volume":"30","author":"Naito","year":"2012","journal-title":"J. Hypertens."},{"key":"ref_35","first-page":"691","article-title":"Effect of Pregnancy on the Levels of Blood Cadmium and Lead: Analysis of 2006\u20132011 Nanjing Maternity and Child Health Care Hospital Survey Data","volume":"42","author":"Liu","year":"2013","journal-title":"Iran. J. Public Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1007\/s00380-017-1013-4","article-title":"Altered expression of intestinal duodenal cytochrome b and divalent metal transporter 1 might be associated with cardio-renal anemia syndrome","volume":"32","author":"Naito","year":"2017","journal-title":"Heart Vessel."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Chen, S.X., Wiseman, C.L., Chakravartty, D., and Cole, D.C. (2017). Metal Concentrations in Newcomer Women and Environmental Exposures: A Scoping Review. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14030277"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"13913","DOI":"10.1007\/s11356-020-11618-x","article-title":"Serum level of lead and cadmium is linked to facial cosmetics use among Iranian young women","volume":"28","author":"Parizi","year":"2021","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/j.fertnstert.2008.01.005","article-title":"Effect of smoking on blood lead levels in workers and role of reactive oxygen species in lead-induced sperm chromatin DNA damage","volume":"91","author":"Hsu","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Richter, P., Faroon, O., and Pappas, R.S. (2017). Cadmium and Cadmium\/Zinc Ratios and Tobacco-Related Morbidities. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14101154"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1080\/10934529.2020.1737459","article-title":"Chronic cadmium exposure and cardiovascular disease in adults","volume":"55","year":"2020","journal-title":"J. Environ. Sci. Health A Toxic Hazard. Subst. Environ. Eng."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jash.2018.03.002","article-title":"Cadmium body burden, hypertension, and changes in blood pressure over time: Results from a prospective cohort study in American Indians","volume":"12","author":"Howard","year":"2018","journal-title":"J. Am. Soc. Hypertens."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/s12011-017-0959-5","article-title":"Cadmium Concentration in Human Autopsy Tissues","volume":"179","author":"Lech","year":"2017","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1007\/s10157-013-0913-6","article-title":"Blood lead and cadmium levels and renal function in Korean adults","volume":"18","author":"Chung","year":"2014","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1038\/nrneph.2018.11","article-title":"Environmental pollution and kidney diseases","volume":"14","author":"Xu","year":"2018","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.envres.2011.07.012","article-title":"Differences in urine cadmium associations with kidney outcomes based on serum creatinine and cystatin C","volume":"111","author":"Weaver","year":"2011","journal-title":"Environ. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.envint.2018.11.002","article-title":"Associations of renal function with urinary excretion of metals: Evidence from NHANES 2003\u20132012","volume":"121","author":"Jin","year":"2018","journal-title":"Environ. Int."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Satarug, S., C Gobe, G., A Vesey, D., and Phelps, K.R. (2020). Cadmium and Lead Exposure, Nephrotoxicity, and Mortality. Toxics, 8.","DOI":"10.3390\/toxics8040086"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1161\/CIRCRESAHA.116.308537","article-title":"Pleiotropic Effects of Statins on the Cardiovascular System","volume":"120","author":"Oesterle","year":"2017","journal-title":"Circ. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s12011-013-9667-y","article-title":"Simvastatin treatment ameliorates injury of rat testes induced by cadmium toxicity","volume":"153","author":"Fouad","year":"2013","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e874","DOI":"10.1038\/cddis.2013.405","article-title":"Zinc chelation: A metallothionein 2A\u2019s mechanism of action involved in osteosarcoma cell death and chemotherapy resistance","volume":"4","author":"Habel","year":"2013","journal-title":"Cell Death Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.taap.2009.03.026","article-title":"Metallothionein protection of cadmium toxicity","volume":"238","author":"Klaassen","year":"2009","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/j.scitotenv.2011.01.037","article-title":"Sources of cadmium exposure among healthy premenopausal women","volume":"409","author":"Adams","year":"2011","journal-title":"Sci. Total. Environ."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"113361","DOI":"10.1016\/j.envpol.2019.113361","article-title":"Cadmium and kidney function: Concentrations, variabilities, and associations across various stages of glomerular function","volume":"256","author":"Jain","year":"2020","journal-title":"Environ. Pollut."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1097\/GME.0000000000001412","article-title":"Statin therapy: Does sex matter?","volume":"26","author":"Faubion","year":"2019","journal-title":"Menopause"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0048-9697(02)00475-8","article-title":"Rice as the most influential source of cadmium intake among general Japanese population","volume":"305","author":"Tsukahara","year":"2003","journal-title":"Sci. Total Environ."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Satarug, S. (2018). Dietary Cadmium Intake and Its Effects on Kidneys. Toxics, 6.","DOI":"10.3390\/toxics6010015"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"110557","DOI":"10.1016\/j.envres.2020.110557","article-title":"Linking metal (Pb, Hg, Cd) industrial air pollution risk to blood metal levels and cardiovascular functioning and structure among children in Syracuse, NY","volume":"193","author":"Hill","year":"2021","journal-title":"Environ. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12337\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:35:06Z","timestamp":1760168106000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/23\/12337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,24]]},"references-count":58,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182312337"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182312337","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,24]]}}}