Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function
Ghosh et al. Environmental Health and Preventive Medicine
Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function
Rishila Ghosh 2
Manushi Siddarth 1
Neeru Singh 2
Vipin Tyagi 2
Pawan Kumar Kare 2
Basu Dev Banerjee 2
Om Prakash Kalra 0
Ashok Kumar Tripathi 2
0 Department of Medicine, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital , Dilshad Garden, Delhi 110095 , India
1 Multidisciplinary Research Unit, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital , Dilshad Garden, Delhi 110095 , India
2 Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital , Dilshad Garden, Delhi 110095 , India
Background: Involvement of agrochemicals have been suggested in the development of chronic kidney disease of unknown etiology (CKDu). The association between CKDu and blood level of organochlorine pesticides (OCPs) in CKDu patients has been examined in the present study. Methods: All the recruited study subjects (n = 300) were divided in three groups, namely, healthy control (n = 100), patients with chronic kidney disease of unknown etiology (n = 100), and patients with chronic kidney disease of known etiology (CKDk) (n = 100). Blood OCP levels of all three study groups were analyzed by gas chromatography. Results: Increased level of OCPs, namely α-HCH, aldrin, and β-endosulfan, were observed in CKDu patients as compared to healthy control and CKD patients of known etiology. The levels of these pesticides significantly correlated negatively with the estimated glomerular filtration rate (eGFR) and positively with urinary albumin of CKD patients. Logistic regression analysis revealed association of γ-HCH, p, p′-DDE, and β-endosulfan with CKDu on adjustment of age, sex, BMI, and total lipid content. Conclusions: Increased blood level of certain organochlorine pesticides is associated with the development of chronic kidney disease of unknown etiology.
Organochlorine pesticides; Chronic kidney disease of unknown etiology; eGFR; Urinary albumin
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CKD may develop as a consequence of (i) systemic
disease such as diabetes (30.6%) and hypertension
(13.2%), (ii) glomerulonephritis (9.9%), and (iii) other
causes including the action of drugs, toxins and metals,
infections, mechanical damage, ischemia, obstruction of
the urinary tract, and genetic alterations [1]. However, in
significant number of CKD cases, the underlying cause
remained unknown. In the recent report of CKD registry
of India, chronic kidney disease of undetermined etiology
(CKDu) was found to be the second most common cause
[2]. CKDu patients are characterized by non-conformation
to the known risk factors such as diabetes, hypertension,
or chronic glomerulonephritis. Although no significant
literature is available which suggest the causes of CKDu,
recently, some reports from El Salvador [3], Central
America [4], Mexico [5], and Sri Lanka [6] have suggested
Background
Chronic kidney disease (CKD) is a complex
pathophysiologic process with multiple etiologies frequently leading to
end-stage renal disease (ESRD). Currently, 10% of the
global population regardless of ethnic origin is affected by
chronic kidney disease. CKD is characterized by progressive
loss of functional glomerular tissue, defects in the
glomerular filter function, and subsequent proteinuria [1]. It shares
a common appearance of glomerulosclerosis, vascular
sclerosis, and tubulointerstitial fibrosis, eventually causing
scarring and nephron loss, thereby perpetuating a vicious cycle
that results in the end-stage kidney disease [1].
* Correspondence:
1Department of Biochemistry, Environmental Biochemistry and Immunology
Laboratory, University College of Medical Sciences (University of Delhi) and
G.T.B. Hospital, Dilshad Garden, Delhi 110095, India
Full list of author information is available at the end of the article
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the possible involvement of agrochemicals in the
development of CKDu.
Organochlorine pesticides are a group of
agrochemicals that were used extensively in yester year for pest
control. Although majority of organochlorine pesticides
(OCPs) are banned in most of the countries, yet they
persist in the environment due to their long half-life and
human expo (...truncated)