Population studies on the association between low-dose environmental cadmium exposure and the risk of chronic kidney disease present conflicting epidemiological evidence, constituting a core uncertainty in current risk assessments. This paper aims to systematically review and synthesize these conflicting findings. By reviewing recent major studies, it first presents key evidence supporting and refuting this association. Subsequently, the article focuses on analyzing the multi-level sources of evidence heterogeneity, including methodological differences in exposure and outcome measurement, interference from strong confounders such as hypertension, the complexity of mixed exposure to multiple metals, and the effect-modifying roles of population age and genetic susceptibility. Finally, based on this analysis, the paper proposes that future research should drive a paradigm shift: moving from single-exposure assessments to mixed-exposure models, and from pursuing uniform risks across entire populations to identifying susceptible subgroups. This shift will facilitate the development of more precise public health prevention and control strategies. This review provides a critical analytical framework and directional guidance for clarifying the renal health risks of low-dose cadmium exposure and integrating conflicting evidence.