Title

Renal Function and exposure to Bisphenol A and phthalates in children with Chronic Kidney Disease.

Document Type

Article

Publication Date

11-1-2018

Identifier

DOI: 10.1016/j.envres.2018.08.006

Abstract

RATIONALE AND OBJECTIVE: Exposure to Bisphenol A (BPA) and phthalates is ubiquitous among adults and children in the United States. Among children and adolescents, those with chronic kidney disease (CKD) are potentially at greater risk of adverse effects from BPA and phthalate exposure. The objective of this study was to evaluate BPA and phthalate exposure among children with CKD and evaluate associations with three measures of kidney function.

STUDY DESIGN: Cross sectional study.

SETTING, PARTICIPANTS, AND MEASUREMENTS: The CKD population was represented by the Chronic Kidney Disease in Children (CKiD) Study, a multicenter, prospective cohort study of children with impaired kidney function in the US. The main outcome was assessment of the relationship between chemical exposures and clinical laboratory findings at enrollment into CKiD. Data collected at baseline from participants 1 to 17 years old (N = 538) were analyzed. Urinary BPA and phthalate levels were evaluated at this time point. Data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative pediatric population, were used for comparison to the CKiD cohort.

RESULTS: Urinary BPA and phthalate levels in the CKiD population were consistently lower than levels detected in healthy children. Additionally, BPA was not significantly associated with blood pressure, proteinuria, or estimated glomerular filtration rate (eGFR). Within the CKiD population, for select individual and combined phthalates, there was an inverse relationship with the urinary protein:creatinine ratio (LMW phthalates, - 9.53% change; 95% CI: - 14.21, - 4.21; p = 0.001), and in most cases, a positive relationship with eGFR (LMW phthalates, a 3.46 unit increase in eGFR, 95% CI: 1.85, 5.07; p < 0.001).

LIMITATIONS: Lack of longitudinal data, limited assessment of diet and nutritional status.

CONCLUSION: In the study cohort, children with CKD did not have increased exposure to BPA and phthalates. Longitudinal studies with repeated measures are likely to be more informative about the possible health effects of prolonged exposure to BPA and phthalates in pediatric patients with CKD.

Journal Title

Environmental research

Volume

167

First Page

575

Last Page

582

MeSH Keywords

Adolescent; Benzhydryl Compounds; Child; Child, Preschool; Cross-Sectional Studies; Humans; Infant; Nutrition Surveys; Phenols; Phthalic Acids; Prospective Studies; Renal Insufficiency, Chronic; United States

Keywords

Bisphenol A; Blood pressure; Children; Chronic Kidney Disease; Glomerular filtration rate; Phthalates; Urinary protein:creatinine ratio

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Environ Res. 2018 Nov;167:575-582. doi: 10.1016/j.envres.2018.08.006. Epub 2018 Aug 9.

Renal Function and exposure to Bisphenol A and phthalates in children with Chronic Kidney Disease.

Malits J1, Attina TM1, Karthikraj R2, Kannan K2, Naidu M1, Furth S3, Warady BA4, Vento S1, Trachtman H5, Trasande L1.

Author information

Abstract

RATIONALE AND OBJECTIVE:

Exposure to Bisphenol A (BPA) and phthalates is ubiquitous among adults and children in the United States. Among children and adolescents, those with chronic kidney disease (CKD) are potentially at greater risk of adverse effects from BPA and phthalate exposure. The objective of this study was to evaluate BPA and phthalate exposure among children with CKD and evaluate associations with three measures of kidney function.

STUDY DESIGN:

Cross sectional study.

SETTING, PARTICIPANTS, AND MEASUREMENTS:

The CKD population was represented by the Chronic Kidney Disease in Children (CKiD) Study, a multicenter, prospective cohort study of children with impaired kidney function in the US. The main outcome was assessment of the relationship between chemical exposures and clinical laboratory findings at enrollment into CKiD. Data collected at baseline from participants 1 to 17 years old (N = 538) were analyzed. Urinary BPA and phthalate levels were evaluated at this time point. Data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative pediatric population, were used for comparison to the CKiD cohort.

RESULTS:

Urinary BPA and phthalate levels in the CKiD population were consistently lower than levels detected in healthy children. Additionally, BPA was not significantly associated with blood pressure, proteinuria, or estimated glomerular filtration rate (eGFR). Within the CKiD population, for select individual and combined phthalates, there was an inverse relationship with the urinary protein:creatinine ratio (LMW phthalates, - 9.53% change; 95% CI: - 14.21, - 4.21; p = 0.001), and in most cases, a positive relationship with eGFR (LMW phthalates, a 3.46 unit increase in eGFR, 95% CI: 1.85, 5.07; p < 0.001).

LIMITATIONS:

Lack of longitudinal data, limited assessment of diet and nutritional status.

CONCLUSION:

In the study cohort, children with CKD did not have increased exposure to BPA and phthalates. Longitudinal studies with repeated measures are likely to be more informative about the possible health effects of prolonged exposure to BPA and phthalates in pediatric patients with CKD.

Copyright © 2018 Elsevier Inc. All rights reserved.

KEYWORDS:

Bisphenol A; Blood pressure; Children; Chronic Kidney Disease; Glomerular filtration rate; Phthalates; Urinary protein:creatinine ratio

PMID:
30172191
DOI:
10.1016/j.envres.2018.08.006
[Indexed for MEDLINE]
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