Cadmium-Induced Chronic Kidney Disease

Itai-Itai Disease is also an Chronic Kidney Disease of non-Traditional causes (CKDnT). From 1910 to the 1960s, wastewater from a mine near the Jinzu river basin in Toyama, Japan, polluted water and rice paddies with heavy metals, including cadmium (Cd). As early as 1912, patients reported bone pain, muscle weakness, and renal failure.

In 1968, the Japanese Ministry of Health and Welfare decided to call this 'Itai-Itai (“ouch-ouch”) disease from chronic cadmium exposure'. Cadmium has an elimination half-life of 10 to 30 years and accumulates in the kidney, slowy killing the organ.

Symptoms include bone pain (hence the name), waddling gait, a marked softening of your bones (osteomalacia) and an irreversible proximal tubular dysfunction that leads to a severe, disabling condition[1]. The only solution is to have a kidney transplant.

High concentrations of cadmium were found in soil, rice, and in pathology specimens of individuals with Itai-Itai[2]. A large 16-year follow-up study identified a dose-related increase in overall age-adjusted mortality, and mortality related to cardiovascular and kidney disease[3].

Elsewhere, in Belgium[4] and Sweden[5], this kidney disease was identified.

Itai-Itai Disease still exists today. Exposure is primarily through contaminated food, smoking or occupational contact.
As this kidney disease has now been observed in numerous countries other than Japan, I would like to propose a new nomenclature: Cadmium-Induced Chronic Kidney Disease.

[1] Emmerson: Ouch-Ouch Disease: The Osteomalacia of Cadmium Nephropathy in Annals of Internal Medicine – 1970
[2] Kobayashi et al: Association between total cadmium intake calculated from the cadmium concentration in household rice and mortality among inhabitants of the cadmium-polluted Jinzu River basin of Japan in Toxicology Letters – 2002
[3] Nishijo et al: Causes of death and renal tubular dysfunction in residents exposed to cadmium in the environment in Occupational and Environmental Medicine – 2006
[4] Buchet et al: Renal effects of cadmium body burden of the general population in Lancet – 1990
[5] Järup et al: Dose-response relations between urinary cadmium and tubular proteinuria in cadmium-exposed workers in American Journal of Industrial Medicine – 1994