The association of perfluoroalkyl substances (PFAS) exposure and kidney function in Korean adolescents using data from Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020): a cross-sectional study

Yun, Jisuk; Jang, Eun-Chul; Kwon, Soon-Chan; Min, Young-Sun; Lee, Yong-Jin

doi:10.35371/aoem.2023.35.e5

Cited by 4 publications

(5 citation statements)

References 39 publications

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“…The implications of our findings are multifaceted, which advances beyond providing awareness and calling for public health intervention to inform future mechanistic research and further understand the complex biological interplay among pollutant mixtures and several chronic and malignant diseases. For instance, the attribution of our findings on metal-and PFAS-induced ROS, which leads to oxidative stress and eventually results in a reduction in kidney function and subsequent damage [81], could be further investigated. This important insight could be useful for the diagnosis of multipollutant-induced chronic disorders and cancers, given the prevalence of multiple pollutants in our environment [84].…”

Section: Discussionmentioning

confidence: 97%

“…Pb, Hg, and Cd, which were ranked second, third, and seventh, respectively, on the 2022 priority list of hazardous substances of the Agency for Toxic Substances and Disease Registry [80]. Studies from Yun et al [81] found individual PFAS and their sum (including PFOA and PFOS) to be significantly associated with decreased eGFR (kidney function). The primary toxic effect of these environmental pollutants is the hypertrophic and histological changes they exert on the kidneys as a result of the increased production of reactive oxygen species (ROS), which results in changes in the permeability of microvascular endothelial cells, leading to a reduction in kidney performance [81,82].…”

Section: Discussionmentioning

confidence: 99%

“…Studies from Yun et al [81] found individual PFAS and their sum (including PFOA and PFOS) to be significantly associated with decreased eGFR (kidney function). The primary toxic effect of these environmental pollutants is the hypertrophic and histological changes they exert on the kidneys as a result of the increased production of reactive oxygen species (ROS), which results in changes in the permeability of microvascular endothelial cells, leading to a reduction in kidney performance [81,82]. These studies only relied on eGFR as a measure of kidney function.…”

Section: Discussionmentioning

confidence: 99%

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Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease

Haruna,

Obeng-Gyasi

2024

IJERPH

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Background: Exposure to environmental pollutants such as metals and Per- and Polyfluoroalkyl Substances (PFAS) has become common and increasingly associated with a decrease in the estimated Glomerular Filtration Rate (eGFR), which is a marker often used to measure chronic kidney disease (CKD). However, there are limited studies involving the use of both eGFR and the urine albumin creatinine ratio (uACR), which are more comprehensive markers to determine the presence of CKD and the complexity of pollutant exposures and response interactions, especially for combined metals and PFAS, which has not been comprehensively elucidated. Objective: This study aims to assess the individual and combined effects of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), Cadmium (Cd), Mercury (Hg), and Lead (Pb) exposure on CKD using data from the National Health and Nutritional Examination Survey (NHANES) 2017–2018. Methods: We employed the use of bivariate logistic regression and Bayesian Kernel Machine Regression (BKMR) in our analysis of the data. Results: Logistic regression results revealed a positive association between PFOA and CKD. Our BKMR analysis revealed a non-linear and bi-phasic relationship between the metal exposures and CKD. In our univariate exposure–response function plot, Cd and Hg exhibited a U and N-shaped interaction, which indicated a non-linear and non-additive relationship with both low and high exposures associated with CKD. In addition, the bivariate exposure–response function between two exposures in a mixture revealed that Cd had a U-shaped relationship with CKD at different quantiles of Pb, Hg, PFOA, and PFOS, indicating that both low and high levels of Cd is associated with CKD, implying a non-linear and complex biological interaction. Hg’s interaction plot demonstrated a N-shaped association across all quantiles of Cd, with the 75th quantile of Pb and the 50th and 75th quantiles of PFOA and PFOS. Furthermore, the PIP results underscored Cd’s consistent association with CKD (PIP = 1.000) followed by Hg’s (PIP = 0.9984), then PFOA and PFOS with a closely related PIP of 0.7880 and 0.7604, respectively, and finally Pb (PIP = 0.6940), contributing the least among the five environmental pollutants on CKD, though significant. Conclusions: Our findings revealed that exposure to environmental pollutants, particularly Hg and Cd, are associated with CKD. These findings highlight the need for public health interventions and strategies to mitigate the cumulative effect of PFAS and metal exposure and elucidate the significance of utilizing advanced statistical methods and tools to understand the impact of environmental pollutants on human health. Further research is needed to understand the mechanistic pathways of PFAS and metal-induced kidney injury and CKD, and longitudinal studies are required to ascertain the long-term impact of these environmental exposures.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease

Haruna,

Obeng-Gyasi

2024

IJERPH

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“…Their intricate network of nephrons and tubules ensures the efficient removal of waste products, excess fluids, and electrolytes from the bloodstream [17]. Consequently, the exploration of the relationship between PFAS exposure and kidney function has assumed a position of paramount importance in the realm of health research [18]. Extensive research in recent years has shed light on the profound impact of PFAS on kidney health.…”

Section: Of 16mentioning

confidence: 99%

Leveraging Machine Learning for a Comprehensive Assessment of PFAS Nephrotoxicity

Panda,

Mazumder

2023

Preprint

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Polyfluoroalkyl substances (PFAS) are persistent chemicals that accumulate in the body and environment. Although recent studies have indicated that PFAS may disrupt kidney function, the underlying mechanisms and overall effects on the organ remain unclear. Therefore, this study aims to elucidate the impact of PFAS on kidney health using machine learning techniques. Utilizing a dataset containing PFAS chemical features and kidney parameters, dimensionality reduction and clustering were performed to identify patterns. Machine learning models, including XGBoost classifier, regressor, and Random Forest regressor, were then developed to predict kidney type from PFAS descriptors, estimate PFAS accumulation in the body, and predict the ratio of glomerular surface area to proximal tubule volume, which indicates kidney filtration efficiency. The kidney type classifier achieved 100% accuracy, confirming that PFAS exposure alters kidney morphology. The PFAS accumulation model attained an R^2 of 1.00, providing a tool to identify at-risk individuals. The ratio prediction model reached an R^2 of 1.00, offering insights into PFAS effects on kidney function. Furthermore, PFAS descriptors and anatomical variables were identified through analyses using feature importance, demonstrating discernible links between PFAS and kidney health, offering further biological significance. Overall, this study can significantly contribute to the current findings on the effect of PFAS while offering machine learning as a contributive tool for similar studies.

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Section: Introductionmentioning

confidence: 99%

Leveraging Machine Learning for a Comprehensive Assessment of PFAS Nephrotoxicity

Mazumder,

Panda

2024

Adv. sci. technol. eng. syst. j.

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The association of perfluoroalkyl substances (PFAS) exposure and kidney function in Korean adolescents using data from Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020): a cross-sectional study

Cited by 4 publications

References 39 publications

Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease

Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease

Leveraging Machine Learning for a Comprehensive Assessment of PFAS Nephrotoxicity

Leveraging Machine Learning for a Comprehensive Assessment of PFAS Nephrotoxicity

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