Elevated Cadmium Levels in Dialysis Patients and Their Links to Inflammation, Oxidative Stress, and Malnutrition

Aim: This study aimed to compare blood cadmium (Cd) levels between hemodialysis (HD) and peritoneal dialysis (PD) patients and healthy controls, and to evaluate the associations between Cd levels and inflammatory, oxidative, and nutritional markers. Material and Methods: Sixty-one dialysis patients (31 HD, 30 PD) and 15 healthy controls were included in this cross-sectional study. Whole-blood Cd was measured by atomic absorption spectrometry and corrected for hemoglobin (cCd). Serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), and advanced oxidation protein products (AOPP) were analyzed as indicators of inflammation and oxidative stress. Results: Both whole-blood Cd and cCd levels were significantly higher in both HD and PD patients compared with healthy controls (p=0.021 and p=0.001, respectively), while no statistically significant difference was observed between the two dialysis modalities. Correlation analyses demonstrated that Cd levels were positively correlated with inflammatory and oxidative stress markers, including IL-6 (rs=0.338, p=0.003), hs-CRP (rs=0.464, p=0.001), MDA (rs=0.464, p=0.001), and AOPP (rs=0.454, p<0.001). In contrast, cCd levels showed a significant negative correlation with serum albumin concentrations (rs=-0.454, p=0.001). Conclusion: Cd accumulation is markedly increased in dialysis patients regardless of treatment modality and is closely linked to systemic inflammation, oxidative damage, and reduced nutritional status. Environmental Cd exposure may represent an under-recognized contributor to adverse clinical outcomes in chronic kidney disease (CKD), and preventive strategies to minimize Cd burden may help improve prognosis in this population.