Low-dose exposure to organophosphate pesticides and chronic kidney disease: insights from urinary dialkyl phosphate biomarkers.

BACKGROUND

Organophosphorus pesticide (OPP) exposure is a public health concern, yet the link between chronic low-level exposure and chronic kidney disease (CKD) in the general population remains unclear.

METHODS

This study investigated the association between urinary dialkyl phosphate (DAP) metabolites and CKD prevalence among U.S. adults. Data from 5751 participants aged ≥ 20 years across five NHANES cycles (2003-2008, 2011-2016) were analyzed. Urinary DAP metabolites served as biomarkers of recent OPP or environmental DAP exposure. CKD associations were assessed using survey-weighted regression models. Secondary mixture analyses, including weighted quantile sum (WQS), Bayesian kernel machine regression (BKMR), and quantile g-computation (QGC), were conducted on metabolites with adequate detection frequency.

RESULTS

Overall, 18.7% of participants met CKD criteria. Higher concentrations of diethylphosphate (DEP) and diethylthiophosphate (DETP) were consistently associated with increased CKD prevalence across models. Mixture analyses identified DEP and DETP as primary contributors to the overall association.

CONCLUSION

This cross-sectional study indicates a potential link between exposure to specific DAPs (DEP and DETP) and an increased risk of CKD, supported by multiple statistical models. Longitudinal research to establish causality and clinical screening for OPPs exposure in unexplained CKD cases is warranted.