The effects of environmental chemicals on renal function

Abstract

The global incidence of chronic kidney disease (CKD) is increasing among individuals of all ages. Despite advances in proteomics, genomics and metabolomics, there remains a lack of safe and effective drugs to reverse or stabilize renal function in patients with glomerular or tubulointerstitial causes of CKD. Consequently, modifiable risk factors that are associated with a progressive decline in kidney function need to be identified. Numerous reports have documented the adverse effects that occur in response to graded exposure to a wide range of environmental chemicals. This Review summarizes the effects of such chemicals on four aspects of cardiorenal function: albuminuria, glomerular filtration rate, blood pressure and serum uric acid concentration. We focus on compounds that individuals are likely to be exposed to as a consequence of normal consumer activities or medical treatment, namely phthalates, bisphenol A, polyfluorinated alkyl acids, dioxins and furans, polycyclic aromatic hydrocarbons and polychlorinated biphenyls. Environmental exposure to these chemicals during everyday life could have adverse consequences on renal function and might contribute to progressive cumulative renal injury over a lifetime. Regulatory efforts should be made to limit individual exposure to environmental chemicals in an attempt to reduce the incidence of cardiorenal disease.

Figure 1

The integrated effects of environmental chemicals on cardiorenal function. The schematic summarizes the potential effects of environmental chemicals on renal and/or vascular function and integrates these effects with the known adverse consequences of obesity and the metabolic syndrome. Abbreviations: BPA, bisphenol A; GFR, glomerular filtration rate; PAH, polycyclic aromatic hydrocarbon; PCB, polychlorinated biphenyl; PFAA, perfluoroalkyl acid.