Phthalates may be linked with rapid disease progression in adults with CKD
Click Here to Manage Email Alerts
Key takeaways:
- Phthalates showed a trend toward higher exposure in patients with chronic kidney disease.
- Urinary chemical concentrations in patients were comparable to those of healthy adults.
Select contaminants within the phthalate class may be linked to more rapid deterioration in kidney function, researchers from New York University found in a recently published study.
“Human exposure to toxic chemicals in the environment is ubiquitous. Exposure to these organic pollutants has been associated with adverse effects on kidney structure and function,” David M. Charytan, MD, of the division of nephrology and department of medicine at the NYU Grossman School of Medicine, wrote along with colleagues.
Researchers conducted a cross-sectional and longitudinal analysis involving 40 adults with chronic kidney disease enrolled in the Chronic Renal Insufficiency Cohort to examine the effects of exposure to various organic chemical pollutants. Patients were assessed for exposure to different chemicals found in plastics, personal care products and food prep and evaluated at 6-month intervals starting from study onset.
Researchers collected data on quality of life, dietary assessment, physical activity, health behaviors, cognitive functions, health care resource utilization, measures of kidney function and the occurrence of new and worsening cardiovascular disease.
Primary outcomes of the study included death; the composite of congestive heart failure, myocardial infarction and stroke; event-free survival from kidney failure or an eGFR decline of at least 50%; and longitudinal trajectory of eGFR.
Of the 52 compounds examined, 30 were detectable in at least 50% of patients, according to the findings. Researchers found that the urinary chemical concentrations in patients with CKD were comparable to those of healthy adults from contemporaneous National Health and Nutrition Examination Survey cohorts. Phthalates demonstrated a trend toward higher exposure in patients with CKD, the findings showed.
Additionally, investigators observed an inverse relationship between exposure and eGFR slope for specific compounds, including bisphenol F, mono-(3-carboxypropyl) phthalate, mono-benzyl phthalate, mono-[2-(carboxymethyl)hexyl] phthalate and melamine. There were no associations between organic pollutant exposure and cardiovascular outcomes.
Simultaneous measurement of multiple organic pollutants in adults with CKD is feasible, the researchers noted, with exposure levels comparable to those in healthy adults.
“These findings provide a useful reference for future studies that aim to evaluate organic pollutant exposure in patients with CKD,” Charytan and colleagues wrote. “This is significant because these exposures represent a modifiable risk factor for disease progression by alterations in diet or lifestyle.”
Collapse
Click Here to Manage Email Alerts