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Schadstoffe und hohe Temperaturen im Zusammenhang mit Nierenveränderungen

von NFI Redaktion

A new study has found that pediatric exposure to current environmental temperatures and particulate matter (PM2.5) is associated with changes in urine and kidney biomarkers, indicating potential subclinical glomerular or tubular damage.

When examining environmental impacts on kidney disease, hospitalization data are often used, where individuals may already have existing or ongoing conditions, write the authors. The aim of this study was to follow a cohort of healthy individuals.

Air pollution is considered one of the greatest health issues due to rapid industrial development. It is classified as a major contributor to global disease burden, as it is associated with respiratory, cardiovascular, reproductive, neurological, and neoplastic diseases.

Estimates suggest that the prevalence of chronic kidney disease worldwide ranges from 11 to 15%, making it a critical issue for global public health. In addition to traditional risk factors such as age and metabolic disorders, current research indicates that rising temperatures due to global warming and exposure to environmental pollutants contribute to the disease process.

Researchers from the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, New York City, collaborated with the National Institute of Public Health and the National Institute of Perinatology in Mexico City for the study published in Science of the Total Environment.

Long-Term Monitoring

Prior reports by the research group showed that prenatal exposure to PM2.5 was associated with higher estimated glomerular filtration rate and increased blood pressure in prepubertal children in Mexico City. To complement previous studies, the goal of this study was to assess the relationship between short-term ambient temperature and PM2.5 exposure with estimated glomerular filtration rate and soluble biomarkers of kidney damage in healthy prepubertal children in Mexico City.

Data were obtained from the „Programming Research in Obesity, Growth, Environment, and Social Stress Factors“ study, wherein pregnant women in their second trimester were recruited between July 2007 and February 2011 through the Mexican Institute of Social Security. Women aged 18 and above, less than 20 weeks pregnant, with no history of kidney or heart disease, no alcohol consumption, and not taking steroids or epilepsy medications were included.

Out of the 948 women who gave birth to a live child, only 571 brought their newborns for a visit at ages 8 to 12, resulting in a population of 437 healthy infants without kidney or cardiovascular diseases and complete data.

Lead author María José Rosa, DrPH, environmental epidemiologist at the Icahn School of Medicine, noted that the biggest challenge in this research was achieving long-term follow-up. „We have been monitoring the participants for 15 years now, so the biggest challenge in conducting this type of research is tracking the original recruitment up to this age to link data with outcomes,“ she said to Medscape Spanish.

Urine and fasting blood samples were collected from each participant. Urine was tested for nine proteins, including glomerular and tubular, while serum cystatin C was quantified from blood samples. The average age was 9.6 years, with an even distribution of males and females.

Satellite models were used to estimate participants‘ temperature and PM2.5 exposure based on their residence. The average temperature in the 7 days prior to sample collection was 16.2°C, ranging from 10.8°C to 21.8°C. The average PM2.5 exposure was 18.7 μg/m3, ranging from 7.5 to 557 μg/m3.

Environmental Implications

No evidence of a relationship between ambient temperature and kidney damage biomarkers was found. However, a correlation was observed between high ambient temperatures and decreased cystatin C.

Exposure to PM2.5 was associated with an increase in albumin, cystatin C, KIM-1, Alpha-1-microglobulin, osteopontin, and glutathione-S-transferase. It was also correlated with a decrease in uromodulin.

Both short-term and long-term (30-day) exposure were associated with an increase in estimated glomerular filtration rate.

Ximena Cortés, MD, pediatric nephrologist at the National Institute of Pediatrics in Mexico City, emphasized that the significance of the research lies in identifying new factors affecting biomarkers for kidney damage. „There is limited information on current environmental influences on the glomerulus, which prompts consideration of situations that also lead to kidney damage and need to be considered when assessing kidney function,“ she said. Cortés was not involved in the study.

She added that tracking participants could provide clearer information. „Comparing glomerular filtration rates in areas with extreme heat to those in areas with colder temperatures and assessing whether this is significant can further enrich research. Additionally, observing participants over a longer period to analyze whether the kidney damage caused is acute or represents chronic damage,“ she said.

Rosa mentioned that cohort follow-up is ongoing with the intention to assess long-term effects. „We have been following the participants since they were 8 to 12 years old,“ she said. „Now, we are working on seeing them for the next five years. We have air pollution data from before their birth, so we aim to analyze whether long-term exposure in one of them leads to the development of kidney disease, or understand the exposure trajectory that could lead to it.“

This work was funded by the National Institute of Environmental Health Sciences (NIEHS) and the National Institutes of Health. Rosa disclosed that NIEHS funding presents a potential conflict of interest. Cortés disclosed no relevant financial conflicts of interest.

This story has been translated from the Spanish edition of Medscape. Multiple editorial tools, including AI, were used in the process. Human editors reviewed this content before publication.

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