Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis

BackgroundRecent studies have investigated the relationship between cadmium exposure and kidney stones. Nevertheless, the results remain controversial. Therefore, we performed a comprehensive systematic review and meta-analysis based on the latest evidence to address gaps in the research.MethodsMedl...

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Main Authors: Zheng-Ju Ren, Qin Zhang, Na-Xian Tang, Ya-Dong Li, Dong-Liang Lu, An-Long Lin, Chuan Yang, Feng Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1555028/full
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author Zheng-Ju Ren
Qin Zhang
Na-Xian Tang
Ya-Dong Li
Dong-Liang Lu
An-Long Lin
Chuan Yang
Feng Wang
author_facet Zheng-Ju Ren
Qin Zhang
Na-Xian Tang
Ya-Dong Li
Dong-Liang Lu
An-Long Lin
Chuan Yang
Feng Wang
author_sort Zheng-Ju Ren
collection DOAJ
description BackgroundRecent studies have investigated the relationship between cadmium exposure and kidney stones. Nevertheless, the results remain controversial. Therefore, we performed a comprehensive systematic review and meta-analysis based on the latest evidence to address gaps in the research.MethodsMedline, Embase, and the Web of Science databases were searched to identify relevant studies up until 31 July 2024. Characteristics and outcomes of the included studies were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. A random effects model was used to determine the association between cadmium exposure and the risk of kidney stones.ResultsA total of 17 studies involving 159,011 individuals were included in the meta-analysis. When comparing the highest versus lowest cadmium exposure levels, the overall relative risk (RR) for kidney stones was 1.19 [95% confidence interval (CI): 1.10–1.29]. Subgroup analysis showed that urinary (RR = 1.19; 95%CI: 1.08–1.30) and blood (RR = 1.49; 95% CI: 1.10–2.02) cadmium levels were associated with an increased risk of kidney stones. In contrast to non-cadmium-contaminated areas, both blood (RR = 1.08; 95% CI: 1.00–1.15) and urinary (RR = 1.16; 95% CI: 1.05–1.27) cadmium levels were associated with an increased risk of kidney stones in cadmium-contaminated areas. In the dose–response meta-analysis, we observed a consistent linear positive association between cadmium exposure and the risk of kidney stones. The overall RR for every 1.0 μg/L increase in urinary cadmium levels was 1.07 (95% CI: 1.01–1.13).ConclusionOur findings suggest that cadmium exposure is associated with the risk of kidney stones. These findings reinforce the importance of environmental cadmium exposure as a risk factor for kidney stones, extending beyond the influence of conventional risk factors. Efforts to reduce cadmium exposure in the population may help reduce the individual, economic, and societal burdens associated with kidney stones.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/myprospero.
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spelling doaj-art-369509fb7c1e4befbda3d987a497009f2025-08-20T03:56:05ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15550281555028Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysisZheng-Ju Ren0Qin Zhang1Na-Xian Tang2Ya-Dong Li3Dong-Liang Lu4An-Long Lin5Chuan Yang6Feng Wang7Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Radiology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, ChinaDepartment of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Urology, Shenzhen University General Hospital, Shenzhen, ChinaDepartment of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaBackgroundRecent studies have investigated the relationship between cadmium exposure and kidney stones. Nevertheless, the results remain controversial. Therefore, we performed a comprehensive systematic review and meta-analysis based on the latest evidence to address gaps in the research.MethodsMedline, Embase, and the Web of Science databases were searched to identify relevant studies up until 31 July 2024. Characteristics and outcomes of the included studies were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. A random effects model was used to determine the association between cadmium exposure and the risk of kidney stones.ResultsA total of 17 studies involving 159,011 individuals were included in the meta-analysis. When comparing the highest versus lowest cadmium exposure levels, the overall relative risk (RR) for kidney stones was 1.19 [95% confidence interval (CI): 1.10–1.29]. Subgroup analysis showed that urinary (RR = 1.19; 95%CI: 1.08–1.30) and blood (RR = 1.49; 95% CI: 1.10–2.02) cadmium levels were associated with an increased risk of kidney stones. In contrast to non-cadmium-contaminated areas, both blood (RR = 1.08; 95% CI: 1.00–1.15) and urinary (RR = 1.16; 95% CI: 1.05–1.27) cadmium levels were associated with an increased risk of kidney stones in cadmium-contaminated areas. In the dose–response meta-analysis, we observed a consistent linear positive association between cadmium exposure and the risk of kidney stones. The overall RR for every 1.0 μg/L increase in urinary cadmium levels was 1.07 (95% CI: 1.01–1.13).ConclusionOur findings suggest that cadmium exposure is associated with the risk of kidney stones. These findings reinforce the importance of environmental cadmium exposure as a risk factor for kidney stones, extending beyond the influence of conventional risk factors. Efforts to reduce cadmium exposure in the population may help reduce the individual, economic, and societal burdens associated with kidney stones.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/myprospero.https://www.frontiersin.org/articles/10.3389/fmed.2025.1555028/fullkidney stonescadmium exposureheavy metalsystematic reviewmeta-analysis
spellingShingle Zheng-Ju Ren
Qin Zhang
Na-Xian Tang
Ya-Dong Li
Dong-Liang Lu
An-Long Lin
Chuan Yang
Feng Wang
Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis
Frontiers in Medicine
kidney stones
cadmium exposure
heavy metal
systematic review
meta-analysis
title Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis
title_full Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis
title_fullStr Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis
title_full_unstemmed Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis
title_short Environmental cadmium exposure and the risk of kidney stones: a systematic review and dose-response meta-analysis
title_sort environmental cadmium exposure and the risk of kidney stones a systematic review and dose response meta analysis
topic kidney stones
cadmium exposure
heavy metal
systematic review
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1555028/full
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AT donglianglu environmentalcadmiumexposureandtheriskofkidneystonesasystematicreviewanddoseresponsemetaanalysis
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