Environmental exposures and pediatric kidney function and disease: A systematic review

Abstract

Background Environmental chemical exposures have been implicated in pediatric kidney disease. No appraisal of the available evidence has been conducted on this topic. Methods We performed a systematic review of the epidemiologic studies that assessed association of environmental exposures with measures of kidney function and disease in pediatric populations. The search period went through July 2016. Results We found 50 studies that met the search criteria and were included in this systematic review. Environmental exposures reviewed herein included lead, cadmium, mercury, arsenic, fluoride, aflatoxin, melamine, environmental tobacco, bisphenol A, dental procedures, phthalates, ferfluorooctanoic acid, triclosan, and thallium/uranium. Most studies assessed environmental chemical exposure via biomarkers but four studies assessed exposure via proximity to emission source. There was mixed evidence of association between metal exposures, and other non-metal environmental exposures and pediatric kidney disease and other kidney disease biomarkers. The evaluation of causality is hampered by the small numbers of studies for each type of environmental exposure, as well as lack of study quality and limited prospective evidence. Conclusion There is a need for well-designed epidemiologic studies of environmental chemical exposures and kidney disease outcomes.

Dietary Sources of Melamine Exposure among US Children and Adults in the National Health and Nutrition Examination Survey 2003–2004

“…Among a convenience sample of US children aged 4 months to 8 years of age, we previously observed a mean urinary melamine concentration of 27.4 ng/mL (SD: 141.9) [ 18 ], markedly higher than the arithmetic mean of 4.1 ng/mL (SE: 0.4) observed among those aged 8 years and older in NHANES. Children are generally more susceptible to environmental exposures compared to adults because of differing metabolisms [ 48 ], higher food and water consumption per unit of body weight [ 49 ], and increased hand-to-mouth ingestion [ 48 ]. This study could not evaluate melamine exposure levels or sources in young children, but this should be pursued in future work.…”

“…Furthermore, our study included data from relatively few children and did not include data from participants younger than 8 years old. Melamine exposure is widespread among children [ 18 ], and because of differing metabolisms, dietary choices, and exposure sources between children and adults [ 49 ], it will be important to further examine the associations of diet and melamine exposure across age groups in future studies.…”

Niños y adolescentes expuestos ambientalmente a mercurio, en diferentes municipios de Colombia

“…Los niños son más sensibles a ciertas exposiciones ambientales [14][15][16][17][18] , por tener frecuencia respiratoria más rápida, superficie pulmonar más grande 19,20 , tener una estatura menor que los adultos y realizar actividades como gatear o jugar en el suelo, donde las concentraciones de vapor de mercurio son más altos [21][22][23] . La contaminación del aire en espacios cerrados y exteriores, la insalubridad del agua, la falta de saneamiento y la higiene inadecuada, causan la muerte de 1,7 millones de niños menores de cinco años.…”

Perinatal and childhood exposure to environmental chemicals and blood pressure in children: a review of literature 2007–2017

“…Although evidence supports this relationship for in utero tobacco exposure and child BP ( 18 , 19 ), the effects of other highly prevalent environmental nephrotoxicants on renal development and BP are poorly understood. We previously reviewed non-BP effects of environmental chemicals on pediatric kidney function and disease ( 20 ).…”