Exposure to environmental pollutants and a marker of early kidney injury in the general population: Results of a nationally representative cross-sectional study based on the Korean National Environmental Health Survey (KoNEHS) 2012–2014

Exposure to environmental pollutants may lead to early kidney injury, chronic kidney disease (CKD) and end-stage renal disease (ESRD). This study investigated the early renal effects associated with exposure to endocrine-disrupting chemicals (EDCs) and heavy metals using general Korean population data. We used data from the Second Korean National Environmental Health Survey (2012–2014). As exposure markers, the concentrations of EDCs, such as triclosan (TCS), bisphenol A (BPA) and phthalate metabolites (DEHP, MnBP and MBzP), and heavy metals, such as cadmium, lead and mercury were analyzed. As an early kidney injury marker, the urinary concentration of β₂-microglobulin (β₂M) was measured. Multiple linear regression was used to analyze the relationship between environmental pollutants and β2M. A total of 5489 people (male: 2538, female: 2951) aged 19 years and older were enrolled. The geometric mean (GM) concentration of β2M in the total population was 1.88 μg/g creatinine (95% confidence interval (CI) 1.85–1.91). The β2M concentrations were significantly higher in cases of female, old age, low income, and presence of a history of diabetes mellitus or hypertension. The GM concentrations of urinary TCS and cadmium were 1.16 μg/g creatinine (95% CI 1.11–1.21) and 0.57 μg/g creatinine (95% CI 0.57–0.59), respectively. TCS, DEHP, cadmium, lead, and mercury exposure was significantly positively related to urinary β2M in the multiple regression analysis. β2M levels increased significantly with increases in the cadmium, mercury, and lead levels (p for trend <0.0001). The higher the DEHP, MnBP, and TCS concentrations, the higher the β2M level (p for trend <0.01). Environmental pollutants exposure significantly increased urinary β2M levels in the general Korean population. To prevent the development of early kidney injury and CKD, it is important to reduce environmental pollutants exposure through regulatory measures, and cooperation between related bodies in both developing and developed countries.