Association of arsenic with kidney function in adolescents and young adults: Results from the National Health and Nutrition Examination Survey 2009-2012

Darcy Weidemann, Chin Chi Kuo, Ana Navas Acien, Alison Gump Abraham, Virginia Marie Weaver, Jeffrey J. Fadrowski

Research output: Contribution to journalArticle

Abstract

Background: Long-term exposure to arsenic is a major public health concern. Emerging evidence suggests adverse health effects even at low levels of exposure. This study examined the association of arsenic exposure with estimated glomerular filtration rate (eGFR) and compared methods of adjustment for urinary dilution in a representative sample of U.S. adolescents and young adults. Methods: We performed a cross-sectional study of 1253 participants ages 12-30 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) with available urinary arsenic and eGFR measures. Multivariable linear regression was used to model the association of urinary total arsenic and dimethylarsinate (DMA) with eGFR. Results: The median urinary total arsenic and DMA concentrations were 6.3μg/L (IQR 3.3-12.7μg/L) and 3.3μg/L (IQR 1.7-5.7μg/L), respectively. Median eGFR was 109mL/min/1.73m2. Adjusting arsenic for urine concentration with urinary creatinine, eGFR was 4.0mL/min/1.73m2 higher (95% confidence interval [CI] 1.0-7.1mL/min/1.73m2) and 4.3mL/min/1.73m2 higher (95% CI 0.5-8.0mL/min/1.73m2) per log-unit increase in total arsenic and DMA, respectively. When using urine osmolality to adjust for urine concentration, a log-unit increase in total arsenic and DMA was associated with a 0.4mL/min/1.73m2 (95% CI -1.8 to 1.1mL/min/1.73m2) and 0.01 (95% CI -1.9 to 1.9mL/min/1.73m2) lower eGFR, respectively. Conclusions: Discordant associations were observed between arsenic and eGFR levels depending on whether urinary creatinine or osmolality was used to adjust for urine concentration. Further study should be dedicated to validating the best approach to account for urinary dilution in research in toxicants, and this may have implications for all studies which examine urinary biomarkers.

Original languageEnglish (US)
Pages (from-to)317-324
Number of pages8
JournalEnvironmental Research
Volume140
DOIs
StatePublished - Jul 1 2015

Fingerprint

health and nutrition
Nutrition Surveys
Arsenic
Nutrition
Young Adult
arsenic
Glomerular Filtration Rate
Health
Kidney
Cacodylic Acid
urine
confidence interval
Urine
Confidence Intervals
Osmolar Concentration
Dilution
Creatinine
dilution
young
Biomarkers

Keywords

  • Arsenic
  • GFR
  • NHANES
  • Urinary creatinine
  • Urine osmolality

ASJC Scopus subject areas

  • Environmental Science(all)
  • Biochemistry

Cite this

@article{0816b05531eb460999bab82d9e3a53c4,
title = "Association of arsenic with kidney function in adolescents and young adults: Results from the National Health and Nutrition Examination Survey 2009-2012",
abstract = "Background: Long-term exposure to arsenic is a major public health concern. Emerging evidence suggests adverse health effects even at low levels of exposure. This study examined the association of arsenic exposure with estimated glomerular filtration rate (eGFR) and compared methods of adjustment for urinary dilution in a representative sample of U.S. adolescents and young adults. Methods: We performed a cross-sectional study of 1253 participants ages 12-30 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) with available urinary arsenic and eGFR measures. Multivariable linear regression was used to model the association of urinary total arsenic and dimethylarsinate (DMA) with eGFR. Results: The median urinary total arsenic and DMA concentrations were 6.3μg/L (IQR 3.3-12.7μg/L) and 3.3μg/L (IQR 1.7-5.7μg/L), respectively. Median eGFR was 109mL/min/1.73m2. Adjusting arsenic for urine concentration with urinary creatinine, eGFR was 4.0mL/min/1.73m2 higher (95{\%} confidence interval [CI] 1.0-7.1mL/min/1.73m2) and 4.3mL/min/1.73m2 higher (95{\%} CI 0.5-8.0mL/min/1.73m2) per log-unit increase in total arsenic and DMA, respectively. When using urine osmolality to adjust for urine concentration, a log-unit increase in total arsenic and DMA was associated with a 0.4mL/min/1.73m2 (95{\%} CI -1.8 to 1.1mL/min/1.73m2) and 0.01 (95{\%} CI -1.9 to 1.9mL/min/1.73m2) lower eGFR, respectively. Conclusions: Discordant associations were observed between arsenic and eGFR levels depending on whether urinary creatinine or osmolality was used to adjust for urine concentration. Further study should be dedicated to validating the best approach to account for urinary dilution in research in toxicants, and this may have implications for all studies which examine urinary biomarkers.",
keywords = "Arsenic, GFR, NHANES, Urinary creatinine, Urine osmolality",
author = "Darcy Weidemann and Kuo, {Chin Chi} and {Navas Acien}, Ana and Abraham, {Alison Gump} and Weaver, {Virginia Marie} and Fadrowski, {Jeffrey J.}",
year = "2015",
month = "7",
day = "1",
doi = "10.1016/j.envres.2015.03.030",
language = "English (US)",
volume = "140",
pages = "317--324",
journal = "Environmental Research",
issn = "0013-9351",
publisher = "Academic Press Inc.",

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TY - JOUR

T1 - Association of arsenic with kidney function in adolescents and young adults

T2 - Results from the National Health and Nutrition Examination Survey 2009-2012

AU - Weidemann, Darcy

AU - Kuo, Chin Chi

AU - Navas Acien, Ana

AU - Abraham, Alison Gump

AU - Weaver, Virginia Marie

AU - Fadrowski, Jeffrey J.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Background: Long-term exposure to arsenic is a major public health concern. Emerging evidence suggests adverse health effects even at low levels of exposure. This study examined the association of arsenic exposure with estimated glomerular filtration rate (eGFR) and compared methods of adjustment for urinary dilution in a representative sample of U.S. adolescents and young adults. Methods: We performed a cross-sectional study of 1253 participants ages 12-30 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) with available urinary arsenic and eGFR measures. Multivariable linear regression was used to model the association of urinary total arsenic and dimethylarsinate (DMA) with eGFR. Results: The median urinary total arsenic and DMA concentrations were 6.3μg/L (IQR 3.3-12.7μg/L) and 3.3μg/L (IQR 1.7-5.7μg/L), respectively. Median eGFR was 109mL/min/1.73m2. Adjusting arsenic for urine concentration with urinary creatinine, eGFR was 4.0mL/min/1.73m2 higher (95% confidence interval [CI] 1.0-7.1mL/min/1.73m2) and 4.3mL/min/1.73m2 higher (95% CI 0.5-8.0mL/min/1.73m2) per log-unit increase in total arsenic and DMA, respectively. When using urine osmolality to adjust for urine concentration, a log-unit increase in total arsenic and DMA was associated with a 0.4mL/min/1.73m2 (95% CI -1.8 to 1.1mL/min/1.73m2) and 0.01 (95% CI -1.9 to 1.9mL/min/1.73m2) lower eGFR, respectively. Conclusions: Discordant associations were observed between arsenic and eGFR levels depending on whether urinary creatinine or osmolality was used to adjust for urine concentration. Further study should be dedicated to validating the best approach to account for urinary dilution in research in toxicants, and this may have implications for all studies which examine urinary biomarkers.

AB - Background: Long-term exposure to arsenic is a major public health concern. Emerging evidence suggests adverse health effects even at low levels of exposure. This study examined the association of arsenic exposure with estimated glomerular filtration rate (eGFR) and compared methods of adjustment for urinary dilution in a representative sample of U.S. adolescents and young adults. Methods: We performed a cross-sectional study of 1253 participants ages 12-30 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) with available urinary arsenic and eGFR measures. Multivariable linear regression was used to model the association of urinary total arsenic and dimethylarsinate (DMA) with eGFR. Results: The median urinary total arsenic and DMA concentrations were 6.3μg/L (IQR 3.3-12.7μg/L) and 3.3μg/L (IQR 1.7-5.7μg/L), respectively. Median eGFR was 109mL/min/1.73m2. Adjusting arsenic for urine concentration with urinary creatinine, eGFR was 4.0mL/min/1.73m2 higher (95% confidence interval [CI] 1.0-7.1mL/min/1.73m2) and 4.3mL/min/1.73m2 higher (95% CI 0.5-8.0mL/min/1.73m2) per log-unit increase in total arsenic and DMA, respectively. When using urine osmolality to adjust for urine concentration, a log-unit increase in total arsenic and DMA was associated with a 0.4mL/min/1.73m2 (95% CI -1.8 to 1.1mL/min/1.73m2) and 0.01 (95% CI -1.9 to 1.9mL/min/1.73m2) lower eGFR, respectively. Conclusions: Discordant associations were observed between arsenic and eGFR levels depending on whether urinary creatinine or osmolality was used to adjust for urine concentration. Further study should be dedicated to validating the best approach to account for urinary dilution in research in toxicants, and this may have implications for all studies which examine urinary biomarkers.

KW - Arsenic

KW - GFR

KW - NHANES

KW - Urinary creatinine

KW - Urine osmolality

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