Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function

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Abstract

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.

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Most cited references 23

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A new equation to estimate glomerular filtration rate.

Andrew Levey, Lesley Stevens, Christopher H Schmid … (2009)

Equations to estimate glomerular filtration rate (GFR) are routinely used to assess kidney function. Current equations have limited precision and systematically underestimate measured GFR at higher values. To develop a new estimating equation for GFR: the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Cross-sectional analysis with separate pooled data sets for equation development and validation and a representative sample of the U.S. population for prevalence estimates. Research studies and clinical populations ("studies") with measured GFR and NHANES (National Health and Nutrition Examination Survey), 1999 to 2006. 8254 participants in 10 studies (equation development data set) and 3896 participants in 16 studies (validation data set). Prevalence estimates were based on 16,032 participants in NHANES. GFR, measured as the clearance of exogenous filtration markers (iothalamate in the development data set; iothalamate and other markers in the validation data set), and linear regression to estimate the logarithm of measured GFR from standardized creatinine levels, sex, race, and age. In the validation data set, the CKD-EPI equation performed better than the Modification of Diet in Renal Disease Study equation, especially at higher GFR (P < 0.001 for all subsequent comparisons), with less bias (median difference between measured and estimated GFR, 2.5 vs. 5.5 mL/min per 1.73 m(2)), improved precision (interquartile range [IQR] of the differences, 16.6 vs. 18.3 mL/min per 1.73 m(2)), and greater accuracy (percentage of estimated GFR within 30% of measured GFR, 84.1% vs. 80.6%). In NHANES, the median estimated GFR was 94.5 mL/min per 1.73 m(2) (IQR, 79.7 to 108.1) vs. 85.0 (IQR, 72.9 to 98.5) mL/min per 1.73 m(2), and the prevalence of chronic kidney disease was 11.5% (95% CI, 10.6% to 12.4%) versus 13.1% (CI, 12.1% to 14.0%). The sample contained a limited number of elderly people and racial and ethnic minorities with measured GFR. The CKD-EPI creatinine equation is more accurate than the Modification of Diet in Renal Disease Study equation and could replace it for routine clinical use. National Institute of Diabetes and Digestive and Kidney Diseases.

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What do we know about chronic kidney disease in India: first report of the Indian CKD registry

Mohan M Rajapurkar, George T. John, Ashok L Kirpalani … (2012)

Background There are no national data on the magnitude and pattern of chronic kidney disease (CKD) in India. The Indian CKD Registry documents the demographics, etiological spectrum, practice patterns, variations and special characteristics. Methods Data was collected for this cross-sectional study in a standardized format according to predetermined criteria. Of the 52,273 adult patients, 35.5%, 27.9%, 25.6% and 11% patients came from South, North, West and East zones respectively. Results The mean age was 50.1 ± 14.6 years, with M:F ratio of 70:30. Patients from North Zone were younger and those from the East Zone older. Diabetic nephropathy was the commonest cause (31%), followed by CKD of undetermined etiology (16%), chronic glomerulonephritis (14%) and hypertensive nephrosclerosis (13%). About 48% cases presented in Stage V; they were younger than those in Stages III-IV. Diabetic nephropathy patients were older, more likely to present in earlier stages of CKD and had a higher frequency of males; whereas those with CKD of unexplained etiology were younger, had more females and more frequently presented in Stage V. Patients in lower income groups had more advanced CKD at presentation. Patients presenting to public sector hospitals were poorer, younger, and more frequently had CKD of unknown etiology. Conclusions This report confirms the emergence of diabetic nephropathy as the pre-eminent cause in India. Patients with CKD of unknown etiology are younger, poorer and more likely to present with advanced CKD. There were some geographic variations.

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Calculation of serum "total lipid" concentrations for the adjustment of persistent organohalogen toxicant measurements in human samples.

John T. Bernert, Donald G. Patterson, Nicholas Turner … (2007)

Persistent organohalogen toxicants such as 2,3,7,8-tetrachlorodibenzo-p-dioxin or polychlorinated biphenyls measured in human serum are often expressed on a lipid weight basis, most commonly by dividing the toxicants' concentration by the weight of total lipids in the sample. Therefore, the manner in which this lipid adjustment is calculated may influence the final reported result. Gravimetric total lipid assays have been used, but they are time-consuming and sometimes may be ill-defined. Consequently, alternative methods using enzymatic assays have been developed based on summing the individual lipid species measured. Recent reports, however, have suggested that significantly different total lipid results may be obtained when using alternative formulae in a summation approach. In this report, we summarize the results obtained from lipid measurements of nearly 900 samples made as part of a study of a group of older American men (mean age 62 years), and we compare our total lipid estimates obtained by using both our standard and "short" formula (the latter based on total cholesterol and triglycerides only) with results obtained using the recently proposed alternative formulae. Our findings indicate that both our long and short formulae provide similar estimates of serum total lipid concentrations, and that differences observed in lipid estimates when using the newer alternative summation methods may reflect differences in how the term "total lipid" is defined, especially with regard to the need to include the contribution of the weight of the cholesterol ester fatty acids in the calculation.

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Author and article information

Contributors

Rishila Ghosh: rishilaghosh@gmail.com

Manushi Siddarth: manushisiddarth@gmail.com

Neeru Singh: neerusingh.2007@gmail.com

Vipin Tyagi: vipintyagimon@gmail.com

Pawan Kumar Kare: pawankare4@gmail.com

Basu Dev Banerjee: banerjeebd@hotmail.com

Om Prakash Kalra: opkalra1@yahoo.com

Ashok Kumar Tripathi: +91-11-22592972-74 , aktripathiucms@gmail.com

Journal

Journal ID (nlm-ta): Environ Health Prev Med

Journal ID (iso-abbrev): Environ Health Prev Med

Title: Environmental Health and Preventive Medicine

Publisher: BioMed Central (London )

ISSN (Print): 1342-078X

ISSN (Electronic): 1347-4715

Publication date (Electronic): 26 May 2017

Publication date PMC-release: 26 May 2017

Publication date (Print): 2017

Volume: 22

Electronic Location Identifier: 49

Affiliations

[1 ]ISNI 0000 0004 1806 781X, GRID grid.412444.3, 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

[2 ]ISNI 0000 0004 1806 781X, GRID grid.412444.3, Multidisciplinary Research Unit, , University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, ; Dilshad Garden, Delhi, 110095 India

[3 ]ISNI 0000 0004 1806 781X, GRID grid.412444.3, Department of Medicine, , University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, ; Dilshad Garden, Delhi, 110095 India

Article

Publisher ID: 660

DOI: 10.1186/s12199-017-0660-5

PMC ID: 5664840

PubMed ID: 29165145

SO-VID: 5ab4fb44-6ec7-402d-9af1-3baa0fc2b0e4

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 12 May 2017

Date accepted : 17 May 2017

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ScienceOpen disciplines: Occupational & Environmental medicine

Keywords: organochlorine pesticides,chronic kidney disease of unknown etiology,egfr,urinary albumin

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ScienceOpen disciplines: Occupational & Environmental medicine

Keywords: organochlorine pesticides, chronic kidney disease of unknown etiology, egfr, urinary albumin

Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function

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Abstract

Background

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Conclusions

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Most cited references 23

A new equation to estimate glomerular filtration rate.

What do we know about chronic kidney disease in India: first report of the Indian CKD registry

Calculation of serum "total lipid" concentrations for the adjustment of persistent organohalogen toxicant measurements in human samples.

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