The role of environmental factors in the development of chronic kidney disease (CKD) – Literature Review

Abstract

The environment is that part of living and non-living nature that surrounds organisms and directly or indirectly affects their existence, development and reproduction.The increase of toxic substances in the environment and the human body beyond the permissible norm leads to a progressive increase in such chronic diseases as: diseases of the respiratory and cardiovascular systems, genetic and congenital malformations, chronic poisoning, malignant tumors, allergies, blood diseases, chronic liver diseases. Chronic kidney disease (CKD) is a global public health problem associated with high rates of morbidity and mortality.It affects > 10% of the total population worldwide, which is > 800 million individuals. Environmental nephrotoxic factors causing CKD can be classified as: (1) metals, (2) air pollution, and (3) exposure to other non-metals. Metals used in industrial processes have been shown to contaminate drinking water, food and soil, thereby increasing the risk of exposure among the general population.In the following sections, we summarize the metals that are known to have a nephrotoxic effect, including arsenic, cadmium, lead, mercury and uranium. a prospective observational study in Taiwan reported that people ingesting ≥ 50 μg/L of As in well water had a 30% increased risk of clinically recognized CKD compared to ≤ 10 μg/L. a cross-sectional study showed that urinary Cd was significantly positively associated with renal tubular biomarkers, including N-acetyl-β-D-glucosaminidase and β2-microglobulin, in the general population in China and Korea.recent studies have investigated the relationship between phthalate exposure and renal function including early renal injury markers such as urine albumin/creatinine ratio and urinary β2-microglobulin (β2M) in different populations.a series of epidemiological studies support the hypothesis that long-term environmental exposure to low-dose melamine can increase the risk of adverse kidney outcomes, including urolithiasis, early renal damage, and the deterioration of kidney function in adults. Most of the epidemiological evidence regarding the association between environmental pollution and kidney disease discussed in this study comes from cross-sectional studies.Studying the interaction between environmental pollutants and genetic factors can help to better understand disease susceptibility, thereby reducing the global burden of morbidity and mortality caused by environmental factors.