Serum bisphenol A as a predictor of chronic kidney disease progression in primary hypertension: a 6-year prospective study

Objective:Hypertensive nephropathy is one of the major causes of chronic kidney disease (CKD). Bisphenol A (BPA) is associated with elevated blood pressure and urinary albuminuria. The aim of this study is to evaluate the association between serum BPA with the progression of CKD in patients with primary hypertension.Methods:In this prospective study, 302 patients with primary hypertension were followed up for 6 years (195 men and 107 women, 65.299.78 years at baseline). The baseline values of serum BPA were measured. Renal function was measured as estimated glomerular filtration rate (eGFR) calculated by the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation (eGFRcr-cys). Regression models were used to calculate associations of serum BPA with the annual change in eGFR and the risk of CKD progression.Results:Baseline serum BPA concentration was 0.61(0.26, 2.44) ng/ml and was significantly negatively correlated with the annual change in eGFR (R=-0.197, P<0.001). After adjusting for clinical factors, baseline serum BPA level had a significant negative association with the annual change in eGFR (=-0.132, P=0.007). Univariate logistic regression analysis showed that the baseline age, SBP, eGFR, and serum BPA levels were predictors of CKD stage 3 or greater. In multivariate logistic regression analysis, patients with high serum BPA levels exhibited a five-fold increased risk of developing CKD stage 3 or greater compared with patients with low serum BPA levels [odds ratio 4.79 (95% confidence interval 1.81, 14.25), P=0.004].Conclusion:Serum BPA may be a predictor of CKD progression in patients with primary hypertension.