Environmental fluoride exposure and implications on potential pediatric kidney health risks: an approach with urinary biomarkers

被引：1

作者：

Gunasekara, T. D. K. S. C. ^{[1
]}

De Silva, P. Mangala C. S. ^{[1
]}

Chandana, E. P. S. ^{[2
]}

Jayasinghe, Sudheera ^{[3
]}

Herath, Chula ^{[4
]}

Siribaddana, Sisira ^{[5
]}

Jayasundara, Nishad ^{[6
]}

机构：

[1] Univ Ruhuna, Fac Sci, Dept Zool, Matara 81000, Sri Lanka

[2] Univ Ruhuna, Fac Technol, Dept Biosyst Technol, Matara 81000, Sri Lanka

[3] Univ Ruhuna, Fac Med, Dept Pharmacol, Galle 80000, Sri Lanka

[4] Sri Jayewardenepura Gen Hosp, Dept Nephrol, Nugegoda 10250, Sri Lanka

[5] Rajarata Univ Sri Lanka, Fac Med & Allied Sci, Dept Med, Saliyapura 50008, Sri Lanka

[6] Duke Univ, Nicholas Sch Environm, Durham, NC 27708 USA

来源：

PEDIATRIC NEPHROLOGY | 2024年 / 39卷 / 05期

关键词：

Biomarkers; Fluoride; Kidney injury; Pediatric; Sri Lanka; INJURY BIOMARKERS; UNKNOWN ETIOLOGY; CHILDREN; WATER; FLUOROSIS; EXCRETION; DISEASE;

D O I：

10.1007/s00467-023-06218-z

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

BackgroundEnvironmental fluoride exposure at elevated levels is potentially linked to kidney injury, and may contribute to chronic kidney disease of uncertain etiology (CKDu) as a risk factor. However, this link remains unclear, and examining the risk of kidney damage from early life fluoride exposure may provide important insights. Hence, this study aimed to investigate associations of fluoride exposure with pediatric kidney health in CKDu impacted and unimpacted communities in Sri Lanka.MethodsConsidering the geographical variations in environmental fluoride, climate, and prevalence of CKDu, four study groups were established within selected education zones in CKDu-endemic dry zone regions (D-En), and CKDu-nonendemic regions within the dry (D-NE), wet (W-NE), and intermediate (I-NE) climatic zones. The study population included 922 school students (11-18 years of age). Participants in each group were divided into four subgroups based on quartiles of respective urinary fluoride (UF) distribution for comparison of urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and albumin-creatinine ratio (ACR).ResultsUF levels in participants particularly in CKDu endemic dry zone regions were significantly high compared to the other regions. Significantly high median urinary NGAL (in D-NE) and ACR (in D-EN, and W-NE) levels were observed in subgroups of higher UF quartiles. Albuminuria was not particularly identified in subjects with high UF excretion. Urinary KIM-1 showed no significant variation across the UF quartile subgroups. Linear regression identified weak associations of UF with kidney injury biomarkers.ConclusionsFluoride exposure is particularly high in CKDu-endemic dry zone communities. As implied by kidney injury biomarkers, a strong link between fluoride exposure and pediatric kidney health was not evident at the observed exposure levels in the study regions.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

引用

页码：1469 / 1480

页数：12