Association of urinary exposure to multiple metal(loid)s with kidney function from a national cross-sectional study.

Yunjiang Yu Wenjie Meng Hongxuan Kuang Xichao Chen Xiaohui Zhu Lebing Wang Haiping Tan Yujie Xu Ping Ding Mingdeng Xiang Guocheng Hu Yang Zhou Guang-Hui Dong

Sci Total Environ

Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China. Electronic address:

Published: July 2023

A study was conducted with 2,210 adults in China to investigate the effects of arsenic, cadmium, copper, selenium, and zinc on kidney function, particularly focusing on the risk of chronic kidney disease (CKD) and impaired renal function (IRF).
Results indicated that higher levels of arsenic, cadmium, copper, selenium, and zinc are linked to increased risks of CKD and IRF, with selenium and copper showing unexpected protective effects.
The study highlights the need for further research on how these metals and metalloids interact and impact kidney health, especially since interactions might influence the adverse effects of these exposures.

Background: Arsenic (As), cadmium (Cd) and copper (Cu) are hazardous for kidney function, while the effects of selenium (Se) and zinc (Zn) were unexplored for the narrow safe range of intake. Interactions exists between these multiple metal/metalloid exposures, but few studies have investigated the effects.

Methods: A cross-sectional survey was performed among 2210 adults across twelve provinces in China between 2020 and 2021. Urinary As, Cd, Cu, Se and Zn were measured using inductively coupled plasma-mass spectrometry (ICP-MS). Serum creatinine (Scr) and N-acetyl-beta-D glucosaminidases (urine NAG) were quantified in serum and urine, respectively. Kidney function was evaluated by the estimated glomerular filtration rate (eGFR). We employed logistic regression and Bayesian kernel machine regression (BKMR) models to explore the individual and joint effects of urinary metals/metalloids on the risk of impaired renal function (IRF) or chronic kidney disease (CKD), respectively.

Results: Association was found between As (OR = 1.24, 95 % CI: 1.03, 1.48), Cd (OR = 1.65, 95 % CI: 1.35, 2.02), Cu (OR = 1.90, 95 % CI: 1.59, 2.29), Se (OR = 1.51, 95 % CI: 1.24, 1.85) and Zn (OR = 1.33, 95 % CI: 1.09, 1.64) and the risk of CKD. Moreover, we observed association between As (OR = 1.18, 95 % CI: 1.07, 1.29), Cu (OR = 1.14, 95 % CI: 1.04, 1.25), Se (OR = 1.15, 95 % CI: 1.06, 1.26) and Zn (OR = 1.12, 95 % CI: 1.02, 1.22) and the risk of IRF. Additionally, it was found that Se exposure may strength the association of urinary As, Cd and Cu with IRF. Furthermore, it is worth noting that Se and Cu contributed greatest to the inverse association in IRF and CKD, respectively.

Conclusion: Our findings suggested that metal/metalloid mixtures were associated with kidney dysfunction, Se and Cu were inverse factors. Additionally, interactions between them may affect the association. Further studies are needed to assess the potential risks for metal/metalloid exposures.

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http://dx.doi.org/10.1016/j.scitotenv.2023.163100	DOI Listing

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