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Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health: A Scoping Review
Open accessAbstract
Background and objectives Per- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants, the impact of PFAS exposure on human health is not well understood, and there are growing concerns for adverse effects on kidney function. Therefore, we conducted a scoping review to summarize and identify gaps in the understanding between PFAS exposure and kidney health. Design, setting, participants, & measurements We systematically searched PubMed, EMBASE, EBSCO Global Health, World Health Organization Global Index, and Web of Science for studies published from 1990 to 2018. We included studies on the epidemiology, pharmacokinetics, or toxicology of PFAS exposure and kidney-related health, including clinical, histologic, molecular, and metabolic outcomes related to kidney disease, or outcomes related to the pharmacokinetic role of the kidneys. Results We identified 74 studies, including 21 epidemiologic, 13 pharmacokinetic, and 40 toxicological studies. Three population-based epidemiologic studies demonstrated associations between PFAS exposure and lower kidney function. Along with toxicology studies ( n =10) showing tubular histologic and cellular changes from PFAS exposure, pharmacokinetic studies ( n =5) demonstrated the kidneys were major routes of elimination, with active proximal tubule transport. In several studies ( n =17), PFAS exposure altered several pathways linked to kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2–related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling. Conclusions A growing body of evidence portends PFASs are emerging environmental threats to kidney health; yet several important gaps in our understanding still exist.
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“PFAS exposure has been associated with dysfunction and genesis of kidney and liver disease, including increased risk for carcinogenesis in these tissues”
From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Stanifer et al., 2018
In the citing paper
“Toxicology studies, including in vivo and in vitro experiments, have identified histological and cellular outcomes indicative of PFAS-induced nephrotoxicity (Shankar et al., 2011; Stanifer et al., 2018). Such findings include oxidative stress, apoptosis, and enhanced microvascular endothelial permeability.”
From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Stanifer et al., 2018
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Metadata
- Authors
- Stanifer, J. W., Stapleton, H. M., Souma, T., Wittmer, A., Zhao, X., & Boulware, L. E.
- Affiliations
- Duke University (US)
- Nicholas School of the Environment, and
- Corresponding author
- Stanifer, John W.
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2018-09-13
- Volume
- 13
- Issue
- 10
- Pages
- 1479-1492
- ISSN
- 1555-9041 (ISSN-L)
- 1555-905X
- PMC
- PMC6218824
- OpenAlex
- W2891379353
- Cited by
- 233
- References
- 89
- Citations by year
- 2026: 25 · 2025: 33 · 2024: 40 · 2023: 33 · 2022: 32 · 2021: 30 · 2020: 23 · 2019: 14 · 2018: 3
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Water Science and Technology › Fluoride Effects and Removal
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Chemical Analysis and Environmental Impact
- Keywords
- per- and polyfluoroalkyl substances, PFAS exposure, kidney health, renal function, kidney disease, nephrotoxicity, pharmacokinetics, oxidative stress, peroxisome proliferator-activated receptors, NF-E2-related factor 2, epithelial-mesenchymal transition, endothelial permeability, actin cytoskeleton, environmental pollutants
- MeSH terms
- Environmental Exposure, Environmental Pollutants, Fluorocarbon Polymers, Humans, Kidney Diseases
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