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Abstract: TH-PO1018

Exposure to Organic Pollutants in Adults with CKD: A Pilot Study

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Trachtman, Howard, University of Michigan, Ann Arbor, Michigan, United States
  • Wu, Wenbo, New York University, New York, New York, United States
  • Kannan, Kurunthachalam, Wadsworth Center, Albany, New York, United States
  • Li, Zhongmin, Wadsworth Center, Albany, New York, United States
  • Pal, Vineet Kumar, Wadsworth Center, Albany, New York, United States
  • Lee, Sunmi, New York University, New York, New York, United States
  • Charytan, David M., New York University, New York, New York, United States
Background

In pediatric patients with chronic kidney disease (CKD), exposure to organic pollutants is associated with intra-renal oxidant stress and tubular injury; however, the impact on longitudinal estimated glomerular filtration rate (eGFR) or proteinuria is minimal. Less is known about the adverse effects of exposure to these chemicals in adults with CKD.

Methods

In this pilot study, we utilized HPLC-MS/MS to measure urinary concentrations of bisphenols, phthalates, organophosphate pesticides, polycyclic aromatic hydrocarbons, melamine, and cyanuric acid at years 1, 3 and 5 after enrollment in 40 adults with CKD from the Chronic Renal Insufficiency Cohort (CRIC) study. We assessed associations with clinical kidney and cardiovascular outcomes, cardiovascular function markers, markers of mineral and bone metabolism, and baseline and longitudinal trajectory of eGFR and proteinuria.

Results

Mean baseline eGFR and urinary protein:creatinine ratio were 33 ml/min/1.73 m2 and 0.58 mg:mg, respectively. Of 52 compounds assayed, 30 were detectable in ≥50% of participants. Urinary chemical concentrations were comparable in CKD patients to healthy subjects from contemporaneous National Health and Nutrition Examination Survey (NHANES) cohorts. Phthalates were the only class with a trend towards higher exposure in CKD patients. In a univariate analysis of time updated exposure to the individual compounds, there was a wide range of association with changes in kidney function. There was an inverse relationship between the level of exposure and eGFR slope for select compounds in the chemical classes including bisphenol F, mono-(3-carboxypropyl) phthalate, mono-benzyl phthalate, mono-[2-(carboxymethyl)hexyl] phthalate, and melamine. There were no significant associations between organic pollutant exposure and cardiovascular outcomes.

Conclusion

Simultaneous measurement of multiple organic pollutants in adults with CKD is feasible. Exposure levels are comparable to that in the healthy population. A subset of contaminants may be associated with more rapid deterioration in kidney function especially in the phthalate class. Our findings provide a useful reference for future studies of the impact of organic pollutant exposure in the CKD population.

Funding

  • NIDDK Support