Environment-wide association study of CKD

Jeonghwan Lee, Sohee Oh, Habyeong Kang, Sunmi Kim, Gowoon Lee, Lilin Li, Clara Tammy Kim, Jung Nam An, Yun Kyu Oh, Chun Soo Lim, Dong Ki Kim, Yon Su Kim, Kyungho Choi, Jung Pyo Lee

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3 Scopus citations


Background and objectives Exposure to environmental chemicals has been recognized as one of the possible contributors to CKD. We aimed to identify environmental chemicals that are associated With CKD. Design, setting, participants, & measurements We analyzed the data obtained from a total of 46,748 adults Who participated in the National Health and Nutrition Examination Survey (1999–2016). Associations of chemicals measured in urine or blood (n=262) With albuminuria (urine albumin-to-creatinine ratio ≤30 mg/g), reduced eGFR (<60 ml/min per 1.73 m2), and a composite of albuminuria or reduced eGFR Were tested and validated using the environment-wide association study approach. Results Among 262 environmental chemicals, seven (3%) chemicals showed significant associations With increased risk of albuminuria, reduced eGFR, or the composite outcome. These chemicals included metals and other chemicals that have not previously been associated With CKD. Serum and urine cotinines, blood 2,5dimethylfuran (a volatile organic compound), and blood cadmium Were associated With albuminuria. Blood lead and cadmium Were associated With reduced eGFR. Blood cadmium and lead and three volatile compounds (blood 2,5-dimethylfuran, blood furan, and urinary phenylglyoxylic acid) Were associatedwith the composite outcome. A total of 23 chemicals, including serum perfluorooctanoic acid, seven urinary metals, three urinary arsenics, urinary nitrate and thiocyanate, three urinary polycyclic aromatic hydrocarbons, and seven volatile organic compounds, Were associated With lower risks of one or more manifestations of CKD. Conclusions A number of chemicals Were identified as potential risk factors for CKD among the general population.

Original languageEnglish
Pages (from-to)766-775
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Issue number6
StatePublished - 8 Jun 2020

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