Kosin Medical Journal

Dietary education may reduce blood cadmium and mercury levels in chronic kidney disease patients with higher blood cadmium and mercury levels: Su Mi Lee, Young-Seoub Hong, Byoung-Gwon Kim, Jung-Yeon Kwon, Yongsoon Park, Seong Eun Kim, Won Suk An; Kosin Med J. 2023;38(2):107-116. Published online May 24, 2023; DOI: https://doi.org/10.7180/kmj.23.101

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Background
Exposure to cadmium and mercury is associated with renal dysfunction. This study aimed to investigate the possible ability of dietary education to decrease blood cadmium and mercury levels in patients with chronic kidney disease (CKD).
Methods
Twenty-seven patients with CKD were enrolled in this prospective, single-arm pilot study. Patients with blood cadmium levels ≥1.4 μg/L were instructed to reduce their intake of shellfish, while those with blood mercury levels ≥5.0 μg/L were asked to reduce their intake of externally blue-colored fish.
Results
Seven dialysis patients and 15 pre-dialysis patients completed the study. Compared with baseline, the blood cadmium (2.0±0.7 μg/L vs. 1.8±0.7 μg/L, p=0.031) and mercury levels (4.4±2.6 μg/L vs. 3.5±1.9 μg/L, p=0.005) after 1 year significantly decreased, although the dietary intake was not significantly different in patients with blood cadmium levels ≥1.4 μg/L and blood mercury levels ≥5.0 μg/L. In pre-dialysis patients, kidney function worsened after 1 year compared with that at baseline despite the reduction in blood cadmium and mercury levels.
Conclusions
Reduction of food intake containing cadmium and mercury may lower the blood cadmium and mercury levels in CKD patients with higher cadmium and mercury levels. Higher blood cadmium levels may cause renal disease progression in pre-dialysis patients, and further studies are necessary to determine the underlying mechanisms.

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Impact of dietary education on blood cadmium and mercury levels in chronic kidney disease: a path to renal health improvement
Ho Sik Shin
Kosin Medical Journal.2023; 38(2): 73. CrossRef

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