Perfluoroalkyl substances exposure and kidney function decline in a community-based prospective cohort

Area of Science:

• Environmental Health
• Toxicology
• Nephrology

Background:

• Per- and polyfluoroalkyl substances (PFAS) are persistent synthetic chemicals with known bioaccumulation and toxicity.
• The kidney is a suspected target organ for PFAS, but human data on specific renal effects are limited.
• Understanding compound-specific associations is vital for public health.

Purpose of the Study:

• To investigate associations between serum PFAS concentrations and renal outcomes in adults.
• To evaluate incident chronic kidney disease (CKD) and kidney function decline over four years.
• To identify specific PFAS compounds and isomers linked to nephrotoxicity.

Main Methods:

• Community-based prospective cohort study of 257 adults (48 with CKD).
• Quantification of eight serum PFAS, including PFHxS, PFOA, PFNA, and PFOS isomers.
• Assessment of kidney outcomes (eGFR, albuminuria) and statistical analysis using regression and spline modeling.

Main Results:

• PFNA and branched perfluorooctanesulfonic acid (Br-PFOS) associated with lower eGFR and higher CKD odds at baseline.
• PFOA showed an inverse association with CKD odds.
• Br-PFOS and PFHxS predicted greater eGFR decline over four years.
• Dose-dependent, compound-specific associations were observed.

Conclusions:

• Findings highlight the importance of isomer-specific PFAS evaluation in human nephrotoxicity.
• Specific PFAS compounds demonstrate distinct associations with kidney function and disease.
• Supports integrating PFAS monitoring into environmental health surveillance and policy.