Association between urinary cobalt exposure and kidney stones in U.S. adult population: results from the National Health and Nutrition Examination Survey

Abstract

Purpose

Heavy metal exposure can cause impaired or reduced pathology in the kidneys, lungs, liver, and other vital organs. However, the relationship between heavy metal exposure and kidney stones has not been determined. The goal of this research was to determine the association between heavy metal exposure and kidney stones in a population of American adults in general.

Materials and methods

We evaluated 29,201 individuals (≥20 years) from the National Health and Nutrition Examination Survey (NHANES). The association between heavy metal exposure and kidney stones was verified by multiple logistic regression and restricted cubic spline (RCS) regression. Dose–response curves were generated to analyze the relationship between heavy metal concentrations and the occurrence of kidney stones. Moreover, we used propensity score matching (PSM) to exclude the effect of confounding variables.

Results

After a rigorous enrollment screening process, we included 8518 participants. Logistic regression showed that urinary cadmium (U-Cd) and urinary cobalt (U-Co) concentrations were significantly different in the kidney stone group before PSM (p < 0.001). Dose–response curves revealed that the occurrence of kidney stones increased significantly with increasing U-Cd and U-Co concentrations. After adjustment for covariates, only biomarkers of U-Co were linked to the occurrence of kidney stones. When the lowest quartile was used as a reference, the 95% confidence intervals (95% CIs) for kidney stones across the other quartiles were 1.015 (0.767–1.344), 1.409 (1.059–1.875), and 2.013 (1.505–2.693) for U-Cos (p < 0.001).

Conclusion

In the U.S. population, high U-Co levels are positively correlated with the potential risk of kidney stones.

Keywords:

• Cobalt
• cadmium
• kidney stones
• NHANES
• cross-sectional survey

Acknowledgments

The authors thank the National Center for Health Statistics of the Centers for Disease Control and Prevention for sharing the data.

Ethical approval statement

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study used previously collected deidentified data, which were deemed exempt from review by the Ethics Committee of Shanghai Fourth People’s Hospital, School of Medicine, Tongji University.

Consent to participate

Not applicable.

Consent to publish

Not applicable.

Author contributions

(I) Conception and design: Jun Lu, Cheng Li. (II) Administrative support: Dongmei Hong and Qian Wu. (III) Provision of study materials or patients: Jun Lu and Yinghui Xia. (IV) Collection and assembly of data: Guozhong Chen and Tie Zhou. (V) Data analysis and interpretation: Dongmei Hong, Qian Wu, and Cheng Li. (VI) Manuscript writing: all authors. (VII) Final approval of manuscript: all authors.

Disclosure statement

The authors declare that they have no competing interests.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This research was supported by the key supporting clinical specialty construction project supported by Hongkou District Health Committee [grant numbers: HKLCFC202409] and Shanghai Fourth People’s Hospital, School of Medicine, Tongji University [grant numbers: sykyqd01901].