Environmental fluoride exposure and implications on potential pediatric kidney health risks: an approach with urinary biomarkers

Systematic Review of Kidney Injury Biomarkers for the Evaluation of CKD of Uncertain Etiology

“… 38 Among adolescents in Sri Lanka, urinary fluoride concentration was weakly associated with urinary NGAL and not suggestive of a significant risk factor for kidney injury ( n = 922). 39 Important limitations of these studies include lack of biomarker normalization to urinary creatinine concentration 36 and lack of adjustment for eGFR, 31 , 36 , 37 , 38 because urine heavy metal and agrochemicals can accumulate in the setting of advanced kidney disease due to reduced clearance. Normalization to 24-hour urinary creatinine concentration is preferred in populations with advanced kidney disease, though impractical.…”

“… 36 Urinary KIM-1 was not associated with urinary concentrations of paraquat or glyphosate in healthy agricultural workers in Sri Lanka ( n = 210) 31 and was minimally associated with urinary fluoride concentration in Sri Lankan adolescents ( n = 922). 39 …”

“…Sci Rep , 2022 95 Sri Lanka 804 total adolescents Urinary KIM-1 Yes Cusabio Technology ELISA (KIM-1 and NGAL) First morning void 164 controls Urinary NGAL 53.2% female Gunasekara et al. Ped Neph 39 Sri Lanka 922 total adolescents Urinary KIM-1 Yes Cusabio Technology ELISA (KIM-1 and NGAL) Early morning void 677 controls Urinary NGAL 54.7% female Sandamini et al. World J Ped , 2022 67 Sri Lanka 892 total adolescents Urinary Cystatin c Yes Cusabio CSB-E08384h (Cystatin c) UACR First morning void 471 controls 52.9% female Ramirez-Rubio et al.…”