The hidden danger: the epigenetic landscape of fluoride-induced kidney damage and its role in chronic kidney disease.

Chronic kidney disease (CKD) manifests as progressive renal impairment, frequently requiring renal replacement therapy. Epigenetic modifications, vital for regulating gene expression and function, play a significant role in chronic kidney disease (CKD) pathogenesis. This review examines the intricate relationship between fluoride exposure and kidney health through epigenetic mechanisms. Although fluoride is well-known for its dental benefits, it has been linked to kidney damage. Fluoride disrupts gene expression patterns, exacerbating renal injury by modulating inflammation, oxidative stress, and mitochondrial dysfunction. Key epigenetic mechanisms mediate fluoride-induced kidney damage, including DNA methylation, histone modifications, and non-coding RNAs. Specifically, alterations in DNA methylation at specific CpG sites are associated with the progression of renal fibrosis. Histone modifications also influence gene expression relevant to kidney function and fibrosis. Additionally, microRNAs, which play a role in renal fibrosis, can be affected by fluoride exposure. A deeper understanding of fluoride's epigenetic impact on kidney damage could reveal new therapeutic targets and preventive strategies. This review highlights the need for further research to elucidate the complex interactions between fluoride exposure, epigenetic changes, and kidney health. Such research is crucial to developing strategies to mitigate renal damage, addressing a significant public health concern.