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Assessing the Impact of Metal and PFAS Exposure on Chronic Kidney Disease: An NHANES Data Analysis

Wei, Nuo (2024) Assessing the Impact of Metal and PFAS Exposure on Chronic Kidney Disease: An NHANES Data Analysis. Master's Thesis, University of Pittsburgh. (Unpublished)

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Chronic exposure to nephrotoxic substances is a public health concern, as these agents can significantly impair renal function, leading to chronic kidney disease (CKD), a condition characterized by a gradual loss of kidney function over time. The goal of this study was to explore whether exposure to certain metals (lead, cadmium, arsenic) and per- and polyfluoroalkyl substances (PFAS) was associated with CKD.
To analyze the association between single and mixed metal and/or PFAS exposures with CKD (n=983) in a nationally representative U.S. population, we utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2011 and 2016 in which CKD was defined by estimated glomerular rate (eGFR) <60 mL/min/1.73m2. Single contaminant survey-weighted models were applied to enhance generalizability to the broader U.S. population. To assess mixture effects, we applied Weighted Quantile Sum (WQS) to assess the contributions of metals and PFAS jointly.
In individual metal models, urinary lead and cadmium were inversely associated with the presence of CKD. In contrast, arsenic, PFOA, and PFOS did not show a significant association with CKD odds. Lead and cadmium were linked to a reduced likelihood of CKD. Age and hypertension were significant covariates, with increased age and the presence of hypertension correlating with higher odds of CKD. The WQS model found that a combined mixture of contaminants was associated with increased eGFR. WQS analysis further identified cadmium and lead as top contributors to the mixture's association with higher continuous eGFR.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Wei, Nuonuw3@pitt.eduNUW30009-0007-0209-2403
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorBuchanich, Jeanine Mjeanine@pitt.eduJEANINE
Committee MemberWang, Jiebiaojbwang@pitt.eduJBWANG
Committee MemberSanders, Alison Paps109@pitt.eduAPS109
Date: 16 May 2024
Date Type: Publication
Defense Date: 26 April 2024
Approval Date: 16 May 2024
Submission Date: 25 April 2024
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 76
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Metal, PFAS, Chronic Kidney Disease
Date Deposited: 16 May 2024 19:36
Last Modified: 16 May 2024 19:36


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