Emerging Endocrine Disrupting Chemicals and Their Impacts in Patients with Renal Disease

Kai-Fan TsaiTaiwan Speaker Emerging Endocrine Disrupting Chemicals and Their Impacts in Patients with Renal DiseaseEnvironmental factors contribute to 22% of global mortality. In Taiwan, which has the highest prevalence of treated end-stage renal disease worldwide, approximately 10% of chronic kidney disease (CKD) cases remain of uncertain etiology. This highlights the urgent need to investigate environmental pollutants, particularly endocrine disrupting chemicals (EDCs), as potential nephrotoxins. Our study details findings from an integrated research project at Kaohsiung Chang Gung Memorial Hospital focusing on two emerging EDC classes in the CKD population: organophosphate flame retardants (OPFRs) and phthalates. Our research demonstrated a nearly 100% detection rate for OPFRs in the study population, indicating universal exposure. Cross-sectional analysis revealed that higher urinary OPFR levels were independently associated with lower eGFR and overt proteinuria, respectively. Notably, a two-year longitudinal study identified high OPFR exposure as a significant predictor for adverse renal events. Regarding phthalates, a one-year longitudinal study of patients with CKD uncovered the associations between phthalate exposure and increased renal injury biomarkers. Mediation analysis showed that exposure to phthalates might induce renal tubular injury through the mechanism of oxidative damage. In conclusion, these findings suggest that EDCs are pervasive environmental threats that might accelerate renal disease progression. Recognizing these hidden culprits is vital for developing preventive strategies and improving long-term outcomes for patients with renal disease.