Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes

Baqiyyah N Conway,1,2 Ashley N Badders,1,3 Tina Costacou,4 John M Arthur,5 Kim E Innes1 1Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA; 2Department of Community Health, School of Rural and Community Health, University of Texas Health Science Cente...

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Autores principales:	Conway BN, Badders AN, Costacou T, Arthur JM, Innes KE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	diabetes anemia chronic kidney disease hypoxia perfluoroalkyl substances Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/e65e140ed11a428a822c53be792acf67
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spelling	oai:doaj.org-article:e65e140ed11a428a822c53be792acf672021-12-02T02:06:36ZPerfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes1178-7007https://doaj.org/article/e65e140ed11a428a822c53be792acf672018-11-01T00:00:00Zhttps://www.dovepress.com/perfluoroalkyl-substances-and-kidney-function-in-chronic-kidney-diseas-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Baqiyyah N Conway,1,2 Ashley N Badders,1,3 Tina Costacou,4 John M Arthur,5 Kim E Innes1 1Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA; 2Department of Community Health, School of Rural and Community Health, University of Texas Health Science Center at Tyler, Tyler, TX, USA; 3Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; 4Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; 5Department of Internal Medicine, Division of Nephrology, University of Arkansas for Medical Sciences, Little Rock, AR, USA Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Four PFAS were investigated: perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid, perfluorooctane sulfonate, and perfluorononanoic acid.Findings: Each PFAS was positively associated with eGFR among those with CKD or anemia; this was the strongest among those with both CKD and anemia, followed by those with CKD uncomplicated by anemia. These relationships were more pronounced among those with diabetes (all P<0.01). In the absence of both CKD and anemia, PFAS was inversely associated with eGFR. Among persons with both anemia and diabetes, when further stratified by CKD stage, compared to an eGFR <30, ORs (95% CI) for being in the eGFR ≥ 90, 60–89, 45–59, and 30–45 range, respectively, were 3.20 (2.00–5.13), 2.64 (1.83–3.80), 3.18 (2.17–4.67), and 1.99 (1.38–2.86) for each ng/dL increase in PFHxS. Results were similar for each PFAS.Interpretation: PFAS are inversely associated with kidney function in CKD and diabetes, with a stronger relation observed when anemia is present. Keywords: diabetes, anemia, chronic kidney disease, hypoxia, perfluoroalkyl substancesConway BNBadders ANCostacou TArthur JMInnes KEDove Medical Pressarticlediabetesanemiachronic kidney diseasehypoxiaperfluoroalkyl substancesSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 11, Pp 707-716 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes anemia chronic kidney disease hypoxia perfluoroalkyl substances Specialties of internal medicine RC581-951
spellingShingle	diabetes anemia chronic kidney disease hypoxia perfluoroalkyl substances Specialties of internal medicine RC581-951 Conway BN Badders AN Costacou T Arthur JM Innes KE Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
description	Baqiyyah N Conway,1,2 Ashley N Badders,1,3 Tina Costacou,4 John M Arthur,5 Kim E Innes1 1Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA; 2Department of Community Health, School of Rural and Community Health, University of Texas Health Science Center at Tyler, Tyler, TX, USA; 3Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; 4Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; 5Department of Internal Medicine, Division of Nephrology, University of Arkansas for Medical Sciences, Little Rock, AR, USA Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Four PFAS were investigated: perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid, perfluorooctane sulfonate, and perfluorononanoic acid.Findings: Each PFAS was positively associated with eGFR among those with CKD or anemia; this was the strongest among those with both CKD and anemia, followed by those with CKD uncomplicated by anemia. These relationships were more pronounced among those with diabetes (all P<0.01). In the absence of both CKD and anemia, PFAS was inversely associated with eGFR. Among persons with both anemia and diabetes, when further stratified by CKD stage, compared to an eGFR <30, ORs (95% CI) for being in the eGFR ≥ 90, 60–89, 45–59, and 30–45 range, respectively, were 3.20 (2.00–5.13), 2.64 (1.83–3.80), 3.18 (2.17–4.67), and 1.99 (1.38–2.86) for each ng/dL increase in PFHxS. Results were similar for each PFAS.Interpretation: PFAS are inversely associated with kidney function in CKD and diabetes, with a stronger relation observed when anemia is present. Keywords: diabetes, anemia, chronic kidney disease, hypoxia, perfluoroalkyl substances
format	article
author	Conway BN Badders AN Costacou T Arthur JM Innes KE
author_facet	Conway BN Badders AN Costacou T Arthur JM Innes KE
author_sort	Conway BN
title	Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
title_short	Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
title_full	Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
title_fullStr	Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
title_full_unstemmed	Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
title_sort	perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/e65e140ed11a428a822c53be792acf67
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Perfluoroalkyl substances and kidney function in chronic kidney disease, anemia, and diabetes

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