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Abstract: TH-PO1050

Environmental Chemical Exposures in African Children with CKD: H3 Africa Cohort Experience

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Trachtman, Howard, NYU Langone Health, New York, New York, United States
  • Trasande, Leonardo, NYU Langone Health, New York, New York, United States
  • Ojo, Akinlolu O., University of Arizona Health Sciences, Tucson, Arizona, United States
  • Adu, Dwomoa, University of Ghana, Accra, Ghana
  • Kannan, Kurunthachalam, Wadsworth Center, New York State Department of Health, Albany, New York, United States
  • Vento, Suzanne M., NYU Langone Health, New York, New York, United States
  • Pehrson, Laura Jane, NYU Langone Health, New York, New York, United States
  • Gilbert, Joseph F., NYU Langone Health, New York, New York, United States
  • Koshy, Tony Thomas, NYU Langone Health, New York, New York, United States
Background

Environmental chemical exposures are linked to oxidative stress and kidney injury in children and adults. This applies to short-lived organic compounds such as bisphenol A and phthalates and persistent synthetic chemicals such as perfluoroalkyl acids (PFAAs). Most investigations to date have been conducted in developed countries with few data about environmental chemical exposures in children living in Africa.

Methods

Clinical and laboratory data about pediatric patients enrolled in the H3 Africa observational cohort study including age, gender, BMI, serum creatinine, eGFR, proteinuria were collected. Serum samples that had been collected at enrollment were retrieved from the Biorepository and analyzed for PFAAs and polybrominated diphenyl ethers (PBDEs) and DDE presticides using established methods. Proteinuria was assessed in a first morning urine sample. Results are presented as mean±SD.

Results

86 patients with CKD (41 M:45 F), age 12.6±2.6 yr old, were included in this nested case control study. The eGFR was 75±4 and the albumin:creatinine ratio was 65±186. The chemical exposures are summarized in the Table. There was no association between exposure (log of serum concentration) to PFAAs and proteinuria. However, controlling for age, gender, and BMI, there was an inverse relationship between eGFR and exposure to PFNA, -21.2 [95% CI:-41.6 - 0.8] and PFDA -18.3 [95% CI:-35.3 - -1.3] ml/min/log unit increase in exposure and a trend towards a similar effect for PFOS. PBDE/DDEs were detected in a small fraction of children and because of small sample size associations with effect markers were not made

Conclusion

PFAA exposure is substantially lower in H3 Africa participants than in healthy US children, age 12-19 enrolled in NHANES 2003-2010. However, even at these lower levels of exposure there was an adverse association between select PFAAs and GFR. These studies indicate the feasibility of measuring environmental chemical exposure in developing countries. The impact of these chemical exposures on kidney function will require larger cohorts of children followed for more extended periods of time.

Serum PFAA levels: H3 Africa Pediatric Patients
ChemicalPFOSPFOAPFHxSPFHxAPFDAPFNA
Concentration (ng/ml)2.4±1.80.53±0.340.3±0.20.7±1.00.2±0.10.34±0.14

Funding

  • NIDDK Support