Abstract
The usage of glyphosate is increasing worldwide. Glyphosate and its major metabolite, aminomethylphosphonic acid (AMPA), are of potential toxicological concern in unknown chronic kidney disease (CKDu). As with Cd and other elements, glyphosate exposure has been reported as risk factor for CKDu in farmers. This study aimed to evaluate the influence of co-exposure to glyphosate and metals or metalloids in chronic kidney disease (CKD). In this study, the urine samples from 55 patients with CKD and 100 participants without CKD were analyzed for glyphosate, arsenic (As), cadmium (Cd), and lead (Pb) concentrations, and estimated glomerular filtration rate (eGFR). Negative associations between glyphosate, AMPA, As, and Cd concentrations in the urine and eGFR were found for study subjects (p < 0.05). With regard to the effect of co-exposure, the odds ratios (OR) for subjects with an eGFR of < 60 mL/min/1.73 m2 was significant because of the high Cd concentration (> 1 μg/g creatinine; OR = 7.57, 95% CI = 1.91–29.95). With regard to the effect of co-exposure, the OR for subjects with an of eGFR < 45 mL/min/1.73 m2 was significant at high glyphosate concentration (> 1 μg/g creatinine; OR = 1.57, 95% CI = 1.13–2.16) and As concentration (> 1 μg/g creatinine; OR = 1.01, 95% CI = 1.00–1.02). These results showed that glyphosate, AMPA, As, and Cd have an effect on CKD; notably, Cd, As, and glyphosate exposure can be important risk factors after stage 3a of CKD, and that there was a co-exposure effect of As and glyphosate in CKD after stage 3b. The potential health impacts of glyphosate should be considered, especial for patients with CKD and eGFR below 45 mL/min/1.73 m2.
Highlights
Since the early 1990s, an unknown chronic kidney disease (CKDu) with compelling tubulointerstitial presentations, called chronic interstitial nephritis, has been reported in agricultural areas of various tropical countries (Jayasumana et al 2015b; Jayasumana et al 2015c; Ruwanpathirana et al 2019), in developing countries without certain chronic etiologies, such as diabetes, hypertension, and glomerulonephritis (Jha et al 2013)
These results showed that glyphosate, aminomethylphosphonic acid (AMPA), As, and Cd have an effect on CKD; notably, Cd, As, and glyphosate exposure can be important risk factors after stage 3a of CKD, and that there was a co-exposure effect of As and glyphosate in CKD after stage 3b
Negative correlations were shown with glyphosate (β=−0.521), AMPA (β=−0.541), As (β=−0.388), and Cd (β=−0.580) concentrations and eGFR in the urine samples from the study subjects (p < 0.05), separately (Table 2)
Summary
Since the early 1990s, an unknown chronic kidney disease (CKDu) with compelling tubulointerstitial presentations, called chronic interstitial nephritis, has been reported in agricultural areas of various tropical countries (Jayasumana et al 2015b; Jayasumana et al 2015c; Ruwanpathirana et al 2019), in developing countries without certain chronic etiologies, such as diabetes, hypertension, and glomerulonephritis (Jha et al 2013). The overall prevalence of CKDu in Sri Lanka has reached 10% , and is as high as 22.9% in several communities; it is the cause of more than 20,000 deaths annually (Jayasumana et al 2015a). In the eco-environmental system, glyphosate and its major metabolite, aminomethylphosphonic acid (AMPA) (Bai et al 2016), are of potential toxicological concern, mainly as a result of the accumulation of residues in topsoil (Silva et al 2018; Yang et al 2015) and the food chain (Bai et al 2016). The major exposure pathway in humans is through the ingestion of the residuals of glyphosate and AMPA in food (Bai et al 2016; FSA 2018); the other routes of exposure are inhalation and dermal contact in occupational workers and farmers (Abdul et al 2021; Cai et al 2017; Jayasumana et al 2015c)
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