Renal Function, Bisphenol A, and Alkylphenols: Results from the National Health and Nutrition Examination Survey (NHANES 2003–2006)

Abstract

BackgroundUrinary excretion of bisphenol A (BPA) and alkylphenols (APs) was used as a biomarker in most previous studies, but no study has investigated whether urinary excretion of these environmental phenols differed by renal function.ObjectiveWe estimated the association between renal function and urinary excretion of BPA and APs.MethodsAnalyses were conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2003–2006. Renal function was measured as estimated glomerular filtration rate (eGFR) calculated by the Modification of Diet in Renal Disease (MDRD) Study equation and by the newly developed Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Regression models were used to calculate geometric means of urinary BPA and APs excretion by eGFR category (≥ 90, 60–90, < 60 mL/min/m2) after adjusting for potential confounding factors.ResultsWhen we used the MDRD Study equation, participants without known renal disease (n = 2,573), 58.2% (n = 1,499) had mildly decreased renal function or undiagnosed chronic kidney disease. The adjusted geometric means for urinary BPA excretion decreased with decreasing levels of eGFR (p for trend = 0.04). The associations appeared primarily in females (p for trend = 0.03). Urinary triclosan excretion decreased with decreasing levels of eGFR (p for trend < 0.01) for both males and females, and the association primarily appeared in participants < 65 years of age. The association between BPA and eGFR was nonsignificant when we used the CKD-EPI equation.ConclusionsUrinary excretion of triclosan, and possibly BPA, decreased with decreasing renal function. The associations might differ by age or sex. Further studies are necessary to replicate our results and understand the mechanism.

Urinary bisphenol A and obesity in adults: results from the Canadian Health Measures Survey

“…All basic models adjusted for sex, age (continuous years), 24 Third, we re-ran the models excluding respondents with self-reported health professional-diagnosed chronic conditions (cardiovascular disease [including heart attack, stroke, and any heart disease], diabetes, and/or kidney disease) that may be related to obesity and BPA exposure/excretion. 28,29 Fourth, since the distribution of full-sample urinary BPA quartiles differed between males and females, we repeated sex-stratified models using sex-specific instead of full-sample quartiles.…”

Systematic review of the literature on triclosan and health outcomes in humans

“…Of the 43 studies, 24 were conducted in North America (Wolff et al , 2010(Wolff et al , 2015Clayton et al 2011;You et al 2011;Buttke et al 2012;Savage et al 2012Savage et al , 2014Koeppe et al 2013;Lankester et al 2013;Buser et al 2014;Spanier et al 2014;Adgent and Rogan 2015;Li et al 2015;Ihde et al 2015;Shiue 2015aShiue , 2015bVelez et al 2015;Ashley-Martin et al 2016;Buckley et al 2016;Poole et al 2016;Scinicariello and Buser 2016;Smarr et al 2017;Geer et al 2017), two studies in the Caribbean (Watkins et al 2015;Aker et al 2016), 10 studies in Europe (Allmyr et al 2009;Chevrier et al 2012;Philippat et al 2012Philippat et al , 2014Bertelsen et al 2013;Buhl et al 2014;Den Hond et al 2013, 2015Geens et al 2015;Lassen et al 2016), four in Asia (Chen et al 2013;Wang et al 2015;Xue et al 2015;Zhu et al 2016), and three in Australia (Cullinan et al 2012(Cullinan et al , 2015a…”

“…For example, 14 US studies used data from the National Health and Nutrition Examination Survey (NHANES) (Clayton et al 2011;You et al 2011;Buttke et al 2012;Savage et al 2012Savage et al , 2014Koeppe et al 2013;Lankester et al 2013;Buser et al 2014;Spanier et al 2014;Adgent and Rogan 2015;Li et al Tier 1: Design: clinical trials/ Exposure: assessment based on a sufficient number of samples per individual to estimate exposure over the appropriate duration, or through the use of adequate long-term sampling; for chemicals for which one sample may be sufficient to fully characterize exposure, inclusion of evidence that errors can be considered sufficiently small; randomized experimental studies with inclusion of increased TCS levels following intervention/ Data analysis: randomization or demonstrated comprehensive evaluation of control variables and included sensitivity analyses. Tier 2: Design: cohort studies and case-control studies with incident cases; studies with both cohort and crosssectional designs/ Exposure: > one sample but without explicit evaluation of error or had > one TCS measure but used each measure as a separate observation; other experimental studies/ Data analysis: applied appropriate statistical methods but did not include sensitivity analyses.…”

“…Only two of the studies examined a similar endpoint. A cross-sectional analysis of the [2003][2004][2005][2006] NHANES data (You et al 2011) observed that persons with lower estimated glomerular filtration rate (a measure of kidney function) tended to have lower levels of urinary TCS (a measure of excretion). By contrast, the placebo-controlled trial of TCS toothpaste (Cullinan et al 2015a(Cullinan et al , 2015b found no evidence that eGFR differed across the two study groups (p ¼ 0.77).…”

Bisphenol A in Chronic Kidney Disease

“…The National Health and Nutrition Examination Survey 2003-2006 (NHANES III) observed in 2573 patients a decrease of urinary excretion of BPA with renal function impairment [35]. The meaning of these data is uncertain: low urinary BPA excretion may relect low exposure to BPA (which would be desirable) or retention of BPA by kidney disease (which would not be desirable).…”