The relationship between metallothionein (MT), chronic exposure to cadmium (Cd), and renal function was investigated in 53 men who were occupationally exposed to Cd. The aim was to determine if MT is a potential biological monitor for chronic exposure to Cd which would be useful for preventing Cd nephropathy. In this study MT excretion, serum MT, and serum creatinine concentrations were significantly higher in subjects with abnormal renal function who had been exposed to Cd. MT excretion was also linearly related on an individual basis to protein excretion, beta 2-microglobulin (beta 2-M) excretion, and cumulative time weighted exposure (dose). MT excretion was also a better predictor of dose than either beta 2-M excretion or Cd excretion. The findings suggest that MT is a potential biological monitor for chronic Cd exposure that would be useful for preventing Cd-induced nephropathy. Further studies of non-specific nephropathies and MT are needed to determine if MT is a specific indicator of proximal tubule function secondary to chronic exposure to Cd.