Effect of renal tubular damage on non‐cancer mortality in the general Japanese population living in cadmium non‐polluted areas

Abstract

AbstractThis study aimed to clarify the cause‐effect relationship between renal tubular damage and non‐cancer mortality in the general Japanese population. We conducted a 19‐year cohort study including 1110 men and 1,03 women who lived in three cadmium‐non‐polluted areas in 1993 or 1994. Mortality risk ratios based on urinary β2‐microglobulin (β2MG) and N‐acetyl‐β‐glucosaminidase (NAG) concentrations were estimated for specific non‐cancer diseases using the Fine and Gray competing risks regression model. In men, continuous urinary NAG (+1 μg/g cre) concentrations were significantly correlated with increased mortality caused by diseases of the respiratory system (hazard ratio (HR): 1.09, 95% confidence interval (CI): 1.03–1.15). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortalities caused by kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00–1.03), renal diseases (HR: 1.01, 95% CI: 1.00–1.03), renal failure (HR: 1.02, 95% CI: 1.00–1.03), and external causes of mortality (HR: 1.01, 95% CI: 1.00–1.02). In women, urinary NAG (+1 μg/g cre) concentrations were significantly associated with increased mortality caused by ischemic heart diseases (HR: 1.02, 95% CI: 1.00–1.04) and kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00–1.04). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortality caused by cardiovascular diseases (HR: 1.01, 95%CI: 1.00–1.02), ischemic heart diseases (HR: 1.01, 95%CI: 1.00–1.02), and kidney and urinary tract diseases (HR: 1.02, 95% CI: 1.01–1.03). The present study indicates that renal tubular damage was significantly related to several non‐cancer disease causes of mortality in Japan's general population living in cadmium‐non‐polluted areas.