Heavy metal nephropathy: considerations for exposure analysis.

Epidemiologic studies have yielded conflicting results regarding the role of heavy metal exposure in recent epidemics of chronic kidney disease (CKD). In this issue of Kidney International, Tsai et al. examined the combined effects of chromium, lead, and cadmium on kidney function using data from the Nutrition and Health Survey in Taiwan. We add this report to our growing understanding of contemporary epidemics of CKD and highlight considerations for exposure analysis in CKD epidemiologic studies.