Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study

BackgroundThe relationship between per- and polyfluoroalkyl substances (PFAS) and kidney function markers remains uncertain.MethodsWe used PFAS detection data from 5,947 adults in NHANES 2005–2012. We employed multivariable linear regression models to examine associations between PFAS and estimated...

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Main Authors: Xue Zhang, Yongping Cao, Xiaona Yang, Fei Ma, Hengyang Zhang, Wenwen Xiao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1569031/full
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author Xue Zhang
Yongping Cao
Xiaona Yang
Fei Ma
Hengyang Zhang
Wenwen Xiao
author_facet Xue Zhang
Yongping Cao
Xiaona Yang
Fei Ma
Hengyang Zhang
Wenwen Xiao
author_sort Xue Zhang
collection DOAJ
description BackgroundThe relationship between per- and polyfluoroalkyl substances (PFAS) and kidney function markers remains uncertain.MethodsWe used PFAS detection data from 5,947 adults in NHANES 2005–2012. We employed multivariable linear regression models to examine associations between PFAS and estimated glomerular filtration rate (eGFR), urine creatinine (UCR), urine albumin (UAL), and urine albumin/creatinine ratio (UACR). To capture non-linear trends, restricted cubic splines were applied. The WQS (weighted quantile sum) and Q-gcomp (quantile g computation) models were used for the mixture analysis. Subgroup analyses were conducted to explore potential interactions.ResultsPerfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (N-MEFOSAA), and perfluorononanoic acid (PFNA) were negatively related to eGFR (β = −2.04, 95% CI = −2.85, −1.23; β = −0.97, 95% CI = −1.78, −0.16; β = −1.50, 95% CI = −2.24, −0.76; β = −0.49, 95% CI = −1.25, 0.27; β = −0.68, 95% CI = −1.46, 0.10). PFOA and PFOS were positive associated with UCR (β = 10.61, 95% CI = −1.89, 23.11; β = 12.98, 95% CI = 0.56, 25.41). PFOA, PFOS, PFHxS, PFNA, and PFUA were negatively related to UAL (β = −0.53, 95% CI = −0.73, −0.32; β = −0.39, 95% CI = −0.59, −0.18; β = −0.59, 95% CI = −0.78, −0.40; β = −0.42, 95% CI = −0.65, −0.19; β = −0.04, 95% CI = −0.22, 0.14). PFDA, PFOA, PFOS, PFHxS, and PFNA are significantly inversely associated with UACR (β = −0.01, 95% CI = −0.16, 0.14; β = −0.52, 95% CI = −0.69, −0.35; β = −0.50, 95% CI = −0.67, −0.33; β = −0.49, 95% CI = −0.64, −0.33; β = −0.27, 95% CI = −0.44, −0.10). Nonlinear relationships were found between PFAS and all kidney function indicators. Mixed PFAS exposure showed a negative association with eGFR, UAL and UACR, while showed a positive relationship with UCR. Interactions between PFASs and most subgroups were observed.ConclusionOur study revealed significant associations between PFAS exposure and various kidney function indicators. These findings provide an epidemiological perspective on how PFAS may lead to kidney dysfunction.
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spelling doaj-art-e6f0db5cc9d743518f00a0123d7ea6352025-08-20T02:40:48ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15690311569031Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population studyXue Zhang0Yongping Cao1Xiaona Yang2Fei Ma3Hengyang Zhang4Wenwen Xiao5School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, ChinaEastern Theater Command Centers for Disease Control and Prevention, Nanjing, ChinaLinping District Center for Disease Control and Prevention, Linping District Health Supervision Institute, Hangzhou, Zhejiang, ChinaEastern Theater Command Centers for Disease Control and Prevention, Nanjing, ChinaEastern Theater Command Centers for Disease Control and Prevention, Nanjing, ChinaEastern Theater Command Centers for Disease Control and Prevention, Nanjing, ChinaBackgroundThe relationship between per- and polyfluoroalkyl substances (PFAS) and kidney function markers remains uncertain.MethodsWe used PFAS detection data from 5,947 adults in NHANES 2005–2012. We employed multivariable linear regression models to examine associations between PFAS and estimated glomerular filtration rate (eGFR), urine creatinine (UCR), urine albumin (UAL), and urine albumin/creatinine ratio (UACR). To capture non-linear trends, restricted cubic splines were applied. The WQS (weighted quantile sum) and Q-gcomp (quantile g computation) models were used for the mixture analysis. Subgroup analyses were conducted to explore potential interactions.ResultsPerfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (N-MEFOSAA), and perfluorononanoic acid (PFNA) were negatively related to eGFR (β = −2.04, 95% CI = −2.85, −1.23; β = −0.97, 95% CI = −1.78, −0.16; β = −1.50, 95% CI = −2.24, −0.76; β = −0.49, 95% CI = −1.25, 0.27; β = −0.68, 95% CI = −1.46, 0.10). PFOA and PFOS were positive associated with UCR (β = 10.61, 95% CI = −1.89, 23.11; β = 12.98, 95% CI = 0.56, 25.41). PFOA, PFOS, PFHxS, PFNA, and PFUA were negatively related to UAL (β = −0.53, 95% CI = −0.73, −0.32; β = −0.39, 95% CI = −0.59, −0.18; β = −0.59, 95% CI = −0.78, −0.40; β = −0.42, 95% CI = −0.65, −0.19; β = −0.04, 95% CI = −0.22, 0.14). PFDA, PFOA, PFOS, PFHxS, and PFNA are significantly inversely associated with UACR (β = −0.01, 95% CI = −0.16, 0.14; β = −0.52, 95% CI = −0.69, −0.35; β = −0.50, 95% CI = −0.67, −0.33; β = −0.49, 95% CI = −0.64, −0.33; β = −0.27, 95% CI = −0.44, −0.10). Nonlinear relationships were found between PFAS and all kidney function indicators. Mixed PFAS exposure showed a negative association with eGFR, UAL and UACR, while showed a positive relationship with UCR. Interactions between PFASs and most subgroups were observed.ConclusionOur study revealed significant associations between PFAS exposure and various kidney function indicators. These findings provide an epidemiological perspective on how PFAS may lead to kidney dysfunction.https://www.frontiersin.org/articles/10.3389/fmed.2025.1569031/fullpolyfluoroalkyl chemicalskidney functioneGFRmixed exposureNational Health and Nutrition Examination Survey
spellingShingle Xue Zhang
Yongping Cao
Xiaona Yang
Fei Ma
Hengyang Zhang
Wenwen Xiao
Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study
Frontiers in Medicine
polyfluoroalkyl chemicals
kidney function
eGFR
mixed exposure
National Health and Nutrition Examination Survey
title Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study
title_full Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study
title_fullStr Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study
title_full_unstemmed Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study
title_short Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study
title_sort association between exposure to per and polyfluoroalkyl substances and kidney function a population study
topic polyfluoroalkyl chemicals
kidney function
eGFR
mixed exposure
National Health and Nutrition Examination Survey
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1569031/full
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