Background and hypothesis: The state of Aguascalientes has the highest prevalence of kidney failure in young adults. A low nephron endowment has been suggested as a possible etiology. This study aims to evaluate the association between exposure to xenobiotics and low kidney volume (KV) at birth.
Methods: This is a cross-sectional, observational, and descriptive study of at-term pregnant women, with no comorbidities. We collected the mother´s urine (MU), amniotic fluid (AF), and neonate´s urine (NU). Metals and non-metals were measured with inductively coupled plasma mass spectrometry, pesticides were determined with high-performance liquid chromatography, and fluoride by ion-selective potentiometry. The total KV adjusted by body surface area (TKVBS) was calculated based on the kidney ultrasound.
Results: Between March-2022 and July-2023, we included 299 women with an average of 24.2 years (± 5.1). 54.2% of neonates were male with an average weight of 3,266 gr (± 399).Factors associated with the TKVBS ≤ 5 percentile were female sex, weight gain during the pregnancy, glomerular filtration rate, methomyl concentration in AF (Odds ratio 7.41, 95% confidence interval 2.31 - 23.8, p= 0.001), 2,4-Dichlorophenoxyacetic (2,4-D) >10 ng/ml in AF (4.99, 1.58 - 15.7, p= 0.002), MU (6.1, 1.9 - 19.7, p= 0.002), and NU (5.1, 1.10 - 26.2, p= 0.023) and fluoride in MU (5.1, 1.10 - 23.5, p= 0.010), and AF (6.76, 1.28 - 35.7, p=0.024). In all matrices (MU, AF and NU) exposure to pesticides was also significantly associated with greater concentrations of electrolytes (Na, K, Ca, PO4 and Mg and oligo-elements (Zn and Fe).
Conclusions: In neonates born to at-term women with no comorbidities, the presence of pesticides and fluoride was associated with low KV. The significant loss of electrolytes and oligoelements associated with pesticides suggests proximal tubulopathy.
Keywords: 2,4-D; fluoride; kidney volume; low nephron endowment; methomyl; pesticides.
© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.