Hanvoravongchai Jidapa, Laochindawat Methasit, Kimura Yusuke, Mise Nathan, Ichihara Sahoko
Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Chemosphere. 2024 Nov;368:143745. doi: 10.1016/j.chemosphere.2024.143745. Epub 2024 Nov 28.
Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals present in the environment that can negatively affect health. Kidney is the major target organ of PFAS exposure, yet the renal impact of PFAS is not completely understood. Here we review the effects of PFAS exposure on kidney health to identify gaps in our understanding and mark potential avenues for future research.
PubMed and SCOPUS databases were searched for studies that examined the association between PFAS exposure and kidney-related outcomes. We included all epidemiological, animal, and cell studies and categorized outcomes into four categories: clinical, histological, molecular and toxicokinetic.
We identified 169 studies, including 51 on clinical outcomes, 28 on histological changes, 42 on molecular mechanisms, and 68 on toxicokinetics. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) exposure were associated with kidney dysfunction, chronic kidney diseases, and increased risk of kidney cancer. Various histological changes were reported, especially in tubular epithelial cells, and the etiology of PFAS-induced kidney injury included various molecular mechanisms. Although PFOA and PFOS are not considered genotoxic, they exhibit several characteristics of carcinogens. Toxicokinetics of PFOA and PFOS differed significantly between species, with renal elimination influenced by various factors such as sex, age, and structure of the compound.
Evidence suggests that PFAS, especially PFOA and PFOS, negatively affects kidney health, though gaps in our understanding of such effects call for further research.
全氟和多氟烷基物质（PFAS）是环境中存在的合成化学品，会对健康产生负面影响。肾脏是PFAS暴露的主要靶器官，但PFAS对肾脏的影响尚未完全了解。在此，我们综述PFAS暴露对肾脏健康的影响，以找出我们理解上的差距，并指明未来研究的潜在方向。
在PubMed和SCOPUS数据库中检索研究PFAS暴露与肾脏相关结局之间关联的研究。我们纳入了所有流行病学、动物和细胞研究，并将结局分为四类：临床、组织学、分子和毒代动力学。
我们识别出169项研究，包括51项关于临床结局的研究、28项关于组织学变化的研究、42项关于分子机制的研究以及68项关于毒代动力学的研究。全氟辛酸（PFOA）和全氟辛烷磺酸（PFOS）暴露与肾功能障碍、慢性肾脏病以及肾癌风险增加有关。报告了各种组织学变化，尤其是肾小管上皮细胞的变化，PFAS诱导的肾损伤病因包括多种分子机制。虽然PFOA和PFOS不被认为具有遗传毒性，但它们具有几种致癌物的特征。PFOA和PFOS的毒代动力学在不同物种之间存在显著差异，肾脏清除受多种因素影响，如性别、年龄和化合物结构。
有证据表明PFAS，尤其是PFOA和PFOS，会对肾脏健康产生负面影响，尽管我们对这些影响的理解存在差距，仍需要进一步研究。
