The associations between renal disease severity and exposure to organophosphate flame retardants in patients with chronic kidney disease. (December 2022)

• Record Type: Journal Article
• Authors: Tsai, Kai-Fan; Cheng, Fu-Jen; Huang, Wan-Ting; Kung, Chia-Te; Lee, Chien-Te; Cheng, Ben-Chung; Chen, Jin-Bor; Li, Shau-Hsuan; Wang, Chin-Chou; Wang, Liang-Jen; Ou, Yu-Che; Lee, Wen-Chin
• Is Part Of: Environment international. Volume 170(2023)
• Publication Date: 2022-12
• Subjects: Bis(2-butoxyethyl) phosphate -- Chronic kidney disease -- Estimated glomerular filtration rate -- Organophosphate flame retardant -- Proteinuria -- Bis(2-chloroethyl) phosphate; Alb albumin -- ALT alanine transaminase -- BBOEP bis(2-butoxyethyl) phosphate -- BCEP bis(2-chloroethyl) phosphate -- BDCPP bis(1, 3-dichloro-2-propyl) phosphate -- BMI body mass index -- Ca serum total calcium -- CI confidence interval -- CKD chronic kidney disease -- CKDu chronic kidney disease of unknown etiology -- COPD chronic obstructive pulmonary disease -- Cr creatinine -- DnBP di-n-butyl phosphate -- DPHP diphenyl phosphate -- eGFR estimated glomerular filtration rate -- ESI electrospray ionization -- ESRD end-stage renal disease -- Hb hemoglobin -- HbA1c glycated hemoglobin -- IQR interquartile range -- K serum potassium -- LOQ limits of quantitation -- n number -- NHANES National Health and Nutrition Examination Survey -- OPFR organophosphate flame retardant -- OR odds ratio -- P serum phosphorus -- PBDE polybrominated diphenyl ether -- PCB polychlorinated biphenyl -- POP persistent organic pollutant -- SPSS Statistical Product and Service Solutions -- TBEP tris(2-butoxyethyl) phosphate -- TC total cholesterol -- TCEP tris(2-chloroethyl) phosphate -- TDCPP tris(1, 3-dichloro-2-propyl) phosphate -- TG triglyceride -- TnBP tri-n-butyl phosphate -- TPHP triphenyl phosphate -- UPCR urinary protein/creatinine ratio -- UPLC ultra-performance liquid chromatography -- UPLC-MS/MS ultra-performance liquid chromatography-tandem mass spectrometry; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2022.107573
• Languages: English
• ISSNs: 0160-4120

Abstract

Graphical abstract: Highlights: Organophosphate flame retardant exposure is common in chronic kidney disease. Urinary organophosphate flame retardant level is associated with renal impairment. Proteinuria could be impacted by organophosphate flame retardant exposure. Organophosphate flame retardant exposure might be altered by age and diet. Abstract: Organophosphate flame retardants (OPFRs) are emerging and widespread environmental pollutants with potential health hazards, including nephrotoxicity. However, the exposure patterns and nephrotoxic potential of OPFRs are yet to be investigated in patients with chronic kidney disease (CKD). We conducted a cross-sectional study involving 166 patients with CKD stratified by estimated glomerular filtration rate (eGFR) and severity of proteinuria. The urinary concentrations of 10 OPFR compounds were measured to evaluate the exposure patterns. Clinical and urinary OPFR profiles were compared among subgroups to identify whether the OPFR compounds were independently correlated with eGFR and proteinuria. Additionally, lifestyle factors were compared among subgroups stratified by median concentrations of urinary OPFR compounds associated with renal disease severity. This study revealed universal exposure to OPFRs in the CKD population, with an overall urinary detection rate of 98.80 %. Furthermore, after adjusting for covariates, the urinary concentration of bis(2-chloroethyl) phosphate (BCEP) was identified as an independent predictor of lower eGFR (low vs high eGFR, odds ratio (OR) (95 % confidence interval (CI)), 1.761 (1.032–3.005) per log μg/g creatinine, p = 0.038), and the urinary concentration of bis(2-butoxyethyl) phosphate (BBOEP) was independently correlated with overt proteinuria in CKD patients (with vs without overt proteinuria, OR (95 % CI), 1.813 (1.065–3.086) per log μg/g creatinine, p = 0.028). Moreover, frequent seafood consumption was negatively correlated with urinary BCEP concentration (high vs low BCEP, OR (95 % CI), 0.455 (0.228–0.908), p = 0.025), and age was inversely associated with urinary BBOEP concentration (high vs low BBOEP, OR (95 % CI), 0.968 (0.937–0.999) per year, p = 0.048). In conclusion, our investigation highlights the extensive exposure to OPFRs and the independent association between renal disease severity and urinary BCEP/BBOEP concentrations in the CKD population, indicating the nephrotoxic potential of these pollutants.