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Kidney Week

Abstract: FR-OR053

Environment-Wide Association Study on CKD in the National Health and Nutrition Examination Survey (1999–2016)

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Lee, Jeonghwan, SMG-SNU Boramae Medical Center, Seoul, Korea (the Republic of)
  • Li, Lilin, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
Background

Effects of environmental chemicals on the development of CKD are not well-investigated. We aimed to investigate which environmental chemicals are significantly associated with the development of CKD.

Methods

A total of 53,348 adult aged above 18 years old participants, who participated in the NHANES surveys over 18 years, were enrolled. The association between environmental chemicals and CKD was tested and validated using the environmental-wide association study (EWAS) methodology. CKD was defined as three categories (albuminuria, urinary albumin to creatinine ratio above 30 mg/g; glomerular filtration rate (GFR), GFR below 60 ml/min/1.73m2; and composite of albuminuria and GFR).

Results

A total of 299 environmental toxins were included in the analysis. Blood lead, urinary antimony and cobalt, blood 1,2-Dichlorobenzene and nitrobenzene were positively associated with CKD defined by albuminuria. In the contrary, perfluorooctanoic acid, perfluorooctane sulfonic acid, urinary nitrate and thiocyanate were negatively associated with CKD defined by albuminuria. Blood lead and cadmium showed positive association with CKD defined by GFR. Other 31 significant environmental factors were all negatively associated with CKD defined by GFR. Blood lead, urinary tungsten, blood 1,2-dichlorobenzene and nitrobenzene, 2,4,5-trichlorophenol, mono-n-butyl phthalate, mono-benzyl phthalate were positively associated with CKD defined both albuminuria and GFR. Urinary mono-benzyl phthalate is associated with increased prevalence of CKD in various categories of albuminuria and GFR.

Conclusion

Urinary mono-benzyl phthalate as well as blood lead are consistently associated with CKD defined by various range of albuminuria, glomerular filtration rate, and composite categories. Increased exposure to lead or mono-benzyl phthalate can be associated with increased prevalence of CKD.

Schematic representation for the association analysis of environmental toxins with chronic kidney disease.