title: Association between perfluoroalkyl acids and kidney function in a cross-sectional study of adolescents.
abstract: BACKGROUND
  Perfluoroalkyl acids are synthetic compounds widely used in industrial and commercial applications. Laboratory studies suggest that these persistent and bioaccumulative chemicals produce oxidant stress and damage glomerular endothelial cells, raising concern regarding the impact of these compounds on renal function.
  
  
  METHODS
  We performed cross-sectional analyses of data 1960 participants aged 12-19 years of the 2003-2010 National Health and Nutrition Examination Surveys. PFAA exposure was assessed using levels of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid, and perfluorohexane sulfonic acid. Primary study outcomes were estimated glomerular filtration rate (eGFR) and serum uric acid.
  
  
  RESULTS
  While adjusting for demographics, cotinine, prehypertension, insulin resistance, body mass index, and hypercholesterolemia, adolescents in the highest PFOA and PFOS quartile had a lower eGFR, 6.84 mL/min/1.73 m(2) (95% CI: 2.19 to 11.48) and 9.69 mL/min/1.73 m(2) (95 % CI: -4.59 to 14.78), respectively, compared to the lowest quartile. Highest PFOA and PFOS quartiles were also associated with 0.21 mg/dL (95% CI: 0.056 to 0.37) and 0.19 mg/dL (95% CI: 0.032 to 0.34) increases in uric acid, respectively.
  
  
  CONCLUSIONS
  PFAAs are associated with a reduction in kidney function and increased uric acid levels in otherwise healthy adolescents. Reverse causation and residual confounding could explain the results. Our study results confirm and amplify previous findings, though longitudinal studies examining prenatal and childhood biomarkers in relationship with robust measures of childhood renal function are needed.
authors.affiliation: Department of Pediatrics, New York University School of Medicine, 227 East 30th St, Room 735, New York, NY, 10016, USA.
authors.forename: Anglina
authors.initials: A
authors.lastname: Kataria
authors.affiliation: Department of Pediatrics, New York University School of Medicine, 227 East 30th St, Room 735, New York, NY, 10016, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Trachtman
authors.affiliation: Department of Pediatrics, New York University School of Medicine, 227 East 30th St, Room 735, New York, NY, 10016, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Malaga-Dieguez
authors.affiliation: Department of Pediatrics, New York University School of Medicine, 227 East 30th St, Room 735, New York, NY, 10016, USA. leonardo.trasande@nyumc.org.|Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA. leonardo.trasande@nyumc.org.|Department of Population Health, New York University School of Medicine, New York, NY, USA. leonardo.trasande@nyumc.org.|New York University Wagner School of Public Service, New York, NY, USA. leonardo.trasande@nyumc.org.|Department of Nutrition, Food Studies, and Public Health, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY, USA. leonardo.trasande@nyumc.org.|New York University Global Institute of Public Health, New York, NY, USA. leonardo.trasande@nyumc.org.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
mesh_terms: D000293:Adolescent; D017738:Alkanesulfonic Acids / Q000097:blood / Q000633:toxicity*; D015415:Biomarkers / Q000097:blood; D002210:Caprylates / Q000097:blood / Q000633:toxicity*; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004785:Environmental Pollutants / Q000097:blood / Q000633:toxicity*; D005227:Fatty Acids; D005260:Female; D005466:Fluorocarbons / Q000097:blood / Q000633:toxicity*; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D013451:Sulfonic Acids / Q000097:blood / Q000633:toxicity*; D014481:United States; D014527:Uric Acid / Q000097:blood
chemical_list: D017738:Alkanesulfonic Acids; D015415:Biomarkers; D002210:Caprylates; D004785:Environmental Pollutants; D005227:Fatty Acids; D005466:Fluorocarbons; D013451:Sulfonic Acids; D014527:Uric Acid; C471071:perfluorohexanesulfonic acid; C101816:perfluoro-n-nonanoic acid; C023036:perfluorooctanoic acid; C076994:perfluorooctane sulfonic acid