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Environmental exposures in young adults with declining kidney function in a population at risk of Mesoamerican nephropathy

Smpokou, Evangelia Theano ; González-Quiroz, Marvin ; Martins, Carla ; Alvito, Paula ; Le Blond, Jennifer ; Glaser, Jason ; Aragón, Aurora ; Wesseling, Catharina ; Nitsch, Dorothea and Pearce, Neil , et al. (2019) In Occupational and environmental medicine 76(12). p.920-926
Abstract

Objectives There is an epidemic of Mesoamerican nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months and decline in kidney function over 2 years. Methods Urine samples collected at baseline (pre-sugarcane harvest) and the first 6 month follow-up (post-sugarcane harvest) visit were tested. Twelve metals... (More)

Objectives There is an epidemic of Mesoamerican nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months and decline in kidney function over 2 years. Methods Urine samples collected at baseline (pre-sugarcane harvest) and the first 6 month follow-up (post-sugarcane harvest) visit were tested. Twelve metals and metalloids (aluminium, total arsenic, cadmium, chromium, cobalt, copper, lead, manganese, mercury, selenium, silicon and strontium) were analysed by inductively coupled plasma-mass spectrometry. Twelve pesticides or their metabolites (2,4-dichlorophenoxyacetic acid, 3-phenoxybenzoic acid, 4-fluoro-3-phenoxybenzoic acid, chloro-3,3,3-trifluoro-1-propen-1-yl-2,2-dimethylcyclopropanecarboxylic acid, cis/trans 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, ethylenethiourea, glyphosate, 4-chloro-2-methylphenoxy acetic acid, 3-hydroxy-pyrimetanil, 5-hydroxytiabendazole, hydroxy-tebuconazole and 3,5,6-trichloro-2-pyridinol) and two mycotoxins (ochratoxin A (OTA) and citrinin (CIT)) were analysed by liquid chromatography coupled-mass spectrometry. Differences in the creatinine-corrected urinary concentrations of the measured exposures between outcome groups (participants with stable vs declining kidney function) were examined. Results Elevated levels of aluminium and total arsenic as well as metabolites of several pesticides were detected across the population. No differences were identified between the declining and stable groups in the levels of metals or pesticides tested. OTA and CIT were below the limit of detection. Conclusions The tested metals, metalloids, pesticides and mycotoxins were not associated with loss of kidney function in participants at-risk of MeN.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
chronic kidney disease of unknown origin (CKDu), environmental toxins, mesoamerican nephropathy (MeN), nephrotoxicity, pesticides
in
Occupational and environmental medicine
volume
76
issue
12
pages
7 pages
publisher
BMJ Publishing Group
external identifiers
  • scopus:85075089857
  • pmid:31562235
ISSN
1351-0711
DOI
10.1136/oemed-2019-105772
language
English
LU publication?
yes
id
27631a0d-36ee-44e1-b135-df93042099d4
date added to LUP
2019-11-28 13:12:29
date last changed
2024-05-16 01:23:27
@article{27631a0d-36ee-44e1-b135-df93042099d4,
  abstract     = {{<p>Objectives There is an epidemic of Mesoamerican nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months and decline in kidney function over 2 years. Methods Urine samples collected at baseline (pre-sugarcane harvest) and the first 6 month follow-up (post-sugarcane harvest) visit were tested. Twelve metals and metalloids (aluminium, total arsenic, cadmium, chromium, cobalt, copper, lead, manganese, mercury, selenium, silicon and strontium) were analysed by inductively coupled plasma-mass spectrometry. Twelve pesticides or their metabolites (2,4-dichlorophenoxyacetic acid, 3-phenoxybenzoic acid, 4-fluoro-3-phenoxybenzoic acid, chloro-3,3,3-trifluoro-1-propen-1-yl-2,2-dimethylcyclopropanecarboxylic acid, cis/trans 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, ethylenethiourea, glyphosate, 4-chloro-2-methylphenoxy acetic acid, 3-hydroxy-pyrimetanil, 5-hydroxytiabendazole, hydroxy-tebuconazole and 3,5,6-trichloro-2-pyridinol) and two mycotoxins (ochratoxin A (OTA) and citrinin (CIT)) were analysed by liquid chromatography coupled-mass spectrometry. Differences in the creatinine-corrected urinary concentrations of the measured exposures between outcome groups (participants with stable vs declining kidney function) were examined. Results Elevated levels of aluminium and total arsenic as well as metabolites of several pesticides were detected across the population. No differences were identified between the declining and stable groups in the levels of metals or pesticides tested. OTA and CIT were below the limit of detection. Conclusions The tested metals, metalloids, pesticides and mycotoxins were not associated with loss of kidney function in participants at-risk of MeN.</p>}},
  author       = {{Smpokou, Evangelia Theano and González-Quiroz, Marvin and Martins, Carla and Alvito, Paula and Le Blond, Jennifer and Glaser, Jason and Aragón, Aurora and Wesseling, Catharina and Nitsch, Dorothea and Pearce, Neil and Norman, Jill and Lindh, Christian H. and Morton, Jackie and Caplin, Ben}},
  issn         = {{1351-0711}},
  keywords     = {{chronic kidney disease of unknown origin (CKDu); environmental toxins; mesoamerican nephropathy (MeN); nephrotoxicity; pesticides}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{920--926}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Occupational and environmental medicine}},
  title        = {{Environmental exposures in young adults with declining kidney function in a population at risk of Mesoamerican nephropathy}},
  url          = {{http://dx.doi.org/10.1136/oemed-2019-105772}},
  doi          = {{10.1136/oemed-2019-105772}},
  volume       = {{76}},
  year         = {{2019}},
}