Cited by 234Per- and polyfluoroalkyl substances researchFluoride Effects and RemovalChemical Analysis and Environmental Impact

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Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health: A Scoping Review

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Stanifer, John W., Stapleton, Heather M., Souma, Tomokazu, Wittmer, Ashley, Zhao, Xinlu, Boulware, L. Ebony·2018·Clinical Journal of the American Society of Nephrology

DOI 10.2215/cjn.04670418PMC PMC6218824

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Abstract

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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“Unlike other species, although men demonstrate longer t1/2 compared with women, it remains unclear the extent to which the proximal tubule handling of PFASs is regulated through sex hormones (32,36).”
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Vearrier, 2013, Serum perfluorooctanoic acid concentration is associated with clinical renal disease but not clinical cardiovascular disease., Clin Toxicol (Phila), 51, 326

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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.
ORCID: Stanifer, John W.
Stapleton, Heather M.
Souma, Tomokazu
Wittmer, Ashley
Boulware, L. Ebony
Venue: Clinical Journal of the American Society of Nephrology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-09-13
Volume: 13
Issue: 10
Pages: 1479-1492
ISSN: 1555-9041 (ISSN-L)
1555-905X
DOI: 10.2215/cjn.04670418
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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Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health: A Scoping Review

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