Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 4:13:1606191.
doi: 10.3389/fpubh.2025.1606191. eCollection 2025.

Exploring the impact of PFAS exposure and sleep duration on kidney stone formation in the U.S. population

Jianbai Chen  1 , Zhiming Zhang  1 , Gongquan Xu  1 , Qisheng Tang  1 , Zhiyong Nie  1 , Jianxin Qiu  1 , Xiaoping Gao  1
Affiliations

Exploring the impact of PFAS exposure and sleep duration on kidney stone formation in the U.S. population

Jianbai Chen et al. Front Public Health. .

Abstract

Background: Perfluoroalkyl substances (PFAS), including perfluorooctane sulfonate (PFOS), are persistent environmental pollutants with potential nephrotoxic effects. Concurrently, sleep duration has been implicated in metabolic dysregulation, influencing kidney function. While individual studies have examined the effects of PFAS exposure and sleep duration on kidney health, their combined impact on kidney stone formation remains largely unexplored.

Methods: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. PFAS exposure was assessed through serum concentrations of multiple perfluoroalkyl compounds. Sleep duration was self-reported and categorized as <7 h or ≥7 h. Kidney stone status was determined through self-reported medical diagnoses. Multivariable logistic regression models were used to examine associations between PFAS exposure, sleep duration, and kidney stone formation, adjusting for demographic and lifestyle confounders. Non-restrictive cubic spline (RCS) analysis was employed to assess potential non-linear relationships.

Results: Among 1,263 participants, 551 (43.6%) reported a history of kidney stones. Higher serum concentrations of PFDE, PFHxS n-PFOS, and Sm-PFOS were significantly associated with increased odds of kidney stone formation (p < 0.05). Participants with sleep duration <7 h had a 1.03-fold higher risk of kidney stones (95% CI: 1.01-1.10, p= 0.007). RCS analysis identified non-linear dose-response relationships for several PFAS compounds suggesting threshold effects. Interaction analysis revealed a synergistic effect between PFAS exposure and insufficient sleep, amplifying kidney stone risk.

Conclusion: Our findings suggest that both PFAS exposure and insufficient sleep independently contribute to kidney stone formation, with evidence of a combined exacerbating effect. These results underscore the importance of addressing environmental exposures and lifestyle factors in kidney stone prevention strategies.

Keywords: PFAS; environmental exposure; kidney stones; metabolic disruption; perfluoroalkyl substances; sleep duration.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the screening process for the study population.
Figure 2
Figure 2
Determination of the association between perfluoroalkyl and polyfluoroalkyl substances and kidney stone by restricted cubic spline (RCS) regression analysis.
Figure 3
Figure 3
Determination of the association between sleep duration and kidney stone by restricted cubic spline (RCS) regression analysis.
Figure 4
Figure 4
Goodness-of-fit validation of cubic spline generalized additive models (GAMs) for PFAS exposure and kidney stone risk.
Figure 5
Figure 5
Subgroup and interaction analyses of the association between perfluoroalkyl and polyfluoroalkyl substances, sleep duration, and kidney stone.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Rosato I, Bonato T, Fletcher T, Batzella E, Canova C. Estimation of per- and polyfluoroalkyl substances (PFAS) half-lives in human studies: a systematic review and meta-analysis. Environ Res. (2024) 242:117743. 10.1016/j.envres.2023.117743 - DOI - PubMed
    1. Yang W, Ling X, He S, Cui H, Yang Z, An H, et al. PPARα/ACOX1 as a novel target for hepatic lipid metabolism disorders induced by per- and polyfluoroalkyl substances: an integrated approach. Environ Int. (2023) 178:108138. 10.1016/j.envint.2023.108138 - DOI - PubMed
    1. Menzel J, Abraham K, Dietrich S, Fromme H, Völkel W, Schwerdtle T, et al. Internal exposure to perfluoroalkyl substances (PFAS) in vegans and omnivores. Int J Hyg Environ Health. (2021) 237:113808. 10.1016/j.ijheh.2021.113808 - DOI - PubMed
    1. Death C, Bell C, Champness D, Milne C, Reichman S, Hagen T. Per- and polyfluoroalkyl substances (PFAS) in livestock and game species: a review. Sci Total Environ. (2021) 774:144795. 10.1016/j.scitotenv.2020.144795 - DOI - PubMed
    1. Koskela A, Ducatman A, Schousboe JT, Nahhas RW, Khalil N. Perfluoroalkyl substances and abdominal aortic calcification. J Occup Environ Med. (2022) 64:287–94. 10.1097/JOM.0000000000002479 - DOI - PubMed

MeSH terms

LinkOut - more resources