Bisphenol a in chronic kidney disease

Exposure to bisphenol A induced oxidative stress, cell death and impaired epithelial homeostasis in the adult Drosophila melanogaster midgut

Recently, the chemical compound Bisphenol A (BPA) has been attracting worldwide attention due to its various toxic effects in animals, including reprotoxicity, neurotoxicity, hepatoxicity, and nephrotoxicity. Here, the midgut of adult Drosophila melanogaster (D. melanogaster), an invertebrate model organism, was employed to investigate the gastrointestinal toxicity of BPA in D. melanogaster and explore its underlying mechanisms of action in insects. As a result, exposure of flies to 0.5 mM BPA resulted in a dramatic morphological alteration of D. melanogaster midgut and decrease in survival rates and climbing ability of flies. Further study indicated that BPA induced high levels of oxidative stress in D. melanogaster midgut due to the imbalance between the production of reactive oxygen species and the activities of cellular antioxidant enzymes, including glutathione-S-transferase, catalase and superoxide dismutase. Oxidative stress induced by BPA then caused intestinal epithelial cell death and gut barrier dysfunction and elevated gut permeability, leading to oxidative injury of midgut epithelium. Antioxidant vitamin E alleviated midgut injury induced by BPA. Subsequently, BPA-induced oxidative injury of midgut further stimulated the proliferation of intestinal stem cell (ISC) and ISC-mediated midgut regeneration, but did not alter cell fate determination of ISCs in Drosophila midgut. Meanwhile, activation of Jun N-terminal kinase signal pathway was found to be required for BPA-induced cell death and tissue regeneration in midgut. Collectively, the present study provided additional evidence from an invertebrate model organism that BPA exposure induced gastrointestinal toxicity in D. melanogaster and further extended our understanding of the molecular mechanisms mediating BPA toxicity in insects.

Single and combined effect of bisphenol A with high sucrose diet on the diabetic and renal tubular dysfunction phenotypes in Drosophila melanogaster

In the present study, effect of exposure of bisphenol A (BPA) and combined exposure of BPA + HSD has been investigated on the glucose homeostasis and associated renal complications in Drosophila. Exposure of 1.0 mM BPA alone induced type 2 diabetes like condition (T2D) in adult male D. melanogaster via oxidative stress. Elevated TGF-β signaling was evident by increased expression of baboon (babo) in BPA exposed organism that stimulated the modulation of extracellular matrix (ECM) component collagen IV resulting in the fibrosis of the Malpighian tubules (MTs). Combined exposure of BPA + HSD (high sucrose diet) resulted in the increased magnitude of T2D and MTs dysfunction parameters. Taken together, the study illustrates that BPA has diabetogenic potential in exposed Drosophila that caused adverse effects on their MTs and combined exposure with BPA and HSD could aggravate the renal tubular dysfunction. The study further suggests the use of Drosophila model to study the environmental chemicals induced diabetes mediated renal dysfunction.

Effect of hollow fiber packing density and housing shape on the solute removal performance of CRRT filters for acute blood purification

Continuous renal replacement therapy (CRRT) has a good therapeutic effect in a variety of diseases, such as acute kidney injury. CRRT filters should feature small membrane surface area, excellent water permeability and solute removal performance for long-term use. Solute removal performance depends on the physicochemical structure of the dialysis membrane as well as on the housing design. On the basis of the same hollow fiber membrane, optimizing the housing design can maximize the performance of the dialysis membrane. In this article, we experimentally demonstrated the influence of hollow fiber packing density (PD) and housing shape (effective hollow fiber length (L) and inner housing diameter (D) ratio (L/D ratio)) on the performance of CRRT filters. In each continuous hemodialysis mode and post-diluted continuous hemodiafiltration mode, we tested nine CRRT filters with the same high-flux membrane but with different PDs (50%, 55%, and 60%) and L/D ratios (2.9, 5.3, and 9.3), and we evaluated the effect of different combinations of the two design factors on solute clearance. Our results showed that unlike with the clearance of small molecular weight solutes, the clearance of medium molecular weight solute was obviously affected by PD and L/D ratio, and the design providing the best removal of medium molecular solutes among the nine experiments was PD = 60% and L/D ratio = 9.3. This article will help address the lack of research on CRRT filter housing design as well as lead to the development of higher performance filters for acute blood purification.

Autism-Related Transcription Factors Underlying the Sex-Specific Effects of Prenatal Bisphenol A Exposure on Transcriptome-Interactome Profiles in the Offspring Prefrontal Cortex

Bisphenol A (BPA) is an environmental risk factor for autism spectrum disorder (ASD). BPA exposure dysregulates ASD-related genes in the hippocampus and neurological functions of offspring. However, whether prenatal BPA exposure has an impact on genes in the prefrontal cortex, another brain region highly implicated in ASD, and through what mechanisms have not been investigated. Here, we demonstrated that prenatal BPA exposure disrupts the transcriptome-interactome profiles of the prefrontal cortex of neonatal rats. Interestingly, the list of BPA-responsive genes was significantly enriched with known ASD candidate genes, as well as genes that were dysregulated in the postmortem brain tissues of ASD cases from multiple independent studies. Moreover, several differentially expressed genes in the offspring's prefrontal cortex were the targets of ASD-related transcription factors, including AR, ESR1, and RORA. The hypergeometric distribution analysis revealed that BPA may regulate the expression of such genes through these transcription factors in a sex-dependent manner. The molecular docking analysis of BPA and ASD-related transcription factors revealed novel potential targets of BPA, including RORA, SOX5, TCF4, and YY1. Our findings indicated that prenatal BPA exposure disrupts ASD-related genes in the offspring's prefrontal cortex and may increase the risk of ASD through sex-dependent molecular mechanisms, which should be investigated further.

Exposure to a "safe" dose of environmental pollutant bisphenol A elevates oxidative stress and modulates vasoactive system in hypertensive rats

Due to the prevalence of hypertension (one of the major risk factors of CVD) in the population, it is necessary to explore the adverse effects of daily tolerable and "safe" dose of bisphenol A (BPA) under hypertensive conditions. The current study exposed the Nω-nitro-l-arginine methyl ester (L-NAME, 40 mg/kg b.w/day) induced hypertensive Wistar rats to BPA (50 μg/kg b.w/day) by oral administration along with appropriate controls for 30 days period. The results illustrate that a 'safe' dose of BPA does not influence the systolic blood pressure (SBP) and levels of circulatory biomarkers of tissue damage. On the other hand, BPA exposure significantly (p < 0.05) elevates the thiobarbituric acid reactive substances (TBARS) content in plasma and tissues (heart, aorta, liver and kidney) in hypertensive rats when compared with respective control (BPA alone exposed) rats. Similarly, a significant modulation of ROS generation in RBC, plasma nitric oxide (NO) level and angiotensin-converting enzyme (ACE) activity was observed only under hypertensive milieu. In conclusion, the observed adverse effects during 'safe' dose of BPA exposure are specific to the hypertensive condition. Therefore, a precise investigation to explore the effects of BPA exposure in vulnerable hypertensive populations is highly suggested.

Strategies to Protect Dialysis Patients against Bisphenol A

Bisphenol A (BPA), also known as 2,2,-bis(4-hydroxyphenyl) propane, is a common component of plastics worldwide. However, it has been shown to act as an endocrine disruptor with some hormonal functions. Furthermore, high levels of BPA have been related to the development of cardiovascular events and the activation of carcinogenesis pathways. Patients with chronic kidney disease (CKD) have higher serum concentrations of BPA due to their impaired renal function. This situation is aggravated in CKD patients requiring dialysis, because the BPA content of dialysis devices (such as, for example, the filters) is added to the lack of excretion. In addition to the development of BPA-free dialysis filters, some techniques can contribute to the reduction of BPA levels in these patients. The aim of this review is to illustrate the impact of BPA on dialysis patients and suggest some strategies to reduce its inherent risks.

Bisphenol a Exposure and Kidney Diseases: Systematic Review, Meta-Analysis, and NHANES 03-16 Study

Bisphenol A (BPA) is a compound that is especially widespread in most commonly used objects due to its multiple uses in the plastic industry. However, several data support the need to restrict its use. In recent years, new implications of BPA on the renal system have been discovered, which denotes the need to expand studies in patients. To this end, a systematic review and a meta-analysis was performed to explore existing literature that examines the BPA-kidney disease paradigm and to determine what and how future studies will need to be carried out. Our systematic review revealed that only few relevant publications have focused on the problem. However, the subsequent meta-analysis revealed that high blood concentrations of BPA could be a factor in developing kidney disease, at least in people with previous pathologies such as diabetes or hypertension. Furthermore, BPA could also represent a risk factor in healthy people whose urinary excretion is higher. Finally, the data analyzed from the NHANES 03-16 cohort provided new evidence on the possible involvement of BPA in kidney disease. Therefore, our results underline the need to carry out a thorough and methodologically homogeneous study, delving into the relationship between urinary and blood BPA, glomerular filtration rate, and urine albumin-to-creatinine ratio, preferably in population groups at risk, and subsequently in the general population, to solve this relevant conundrum with critical potential implications in Public Health.

Bisphenol A Modulates Autophagy and Exacerbates Chronic Kidney Damage in Mice

BACKGROUND

Bisphenol A (BPA) is a ubiquitous environmental toxin that accumulates in chronic kidney disease (CKD). Our aim was to explore the effect of chronic exposition of BPA in healthy and injured kidney investigating potential mechanisms involved.

METHODS

In C57Bl/6 mice, administration of BPA (120 mg/kg/day, i.p for 5 days/week) was done for 2 and 5 weeks. To study BPA effect on CKD, a model of subtotal nephrectomy (SNX) combined with BPA administration for 5 weeks was employed. In vitro studies were done in human proximal tubular epithelial cells (HK-2 line).

RESULTS

Chronic BPA administration to healthy mice induces inflammatory infiltration in the kidney, tubular injury and renal fibrosis (assessed by increased collagen deposition). Moreover, in SNX mice BPA exposure exacerbates renal lesions, including overexpression of the tubular damage biomarker Hepatitis A virus cellular receptor 1 (Havcr-1/KIM-1). BPA upregulated several proinflammatory genes and increased the antioxidant response [Nuclear factor erythroid 2-related factor 2 (Nrf2), Heme Oxygenase-1 (Ho-1) and NAD(P)H dehydrogenase quinone 1 (Nqo-1)] both in healthy and SNX mice. The autophagy process was modulated by BPA, through elevated autophagy-related gene 5 (Atg5), autophagy-related gene 7 (Atg7), Microtubule-associated proteins 1A/1B light chain 3B (Map1lc3b/Lc3b) and Beclin-1 gene levels and blockaded the autophagosome maturation and flux (p62 levels). This autophagy deregulation was confirmed in vitro.

CONCLUSIONS

BPA deregulates autophagy flux and redox protective mechanisms, suggesting a potential mechanism of BPA deleterious effects in the kidney.

Associations of serum bisphenol A levels with incident chronic kidney disease risk

Associations of bisphenol A (BPA) levels with renal disease are inconsistent. The present prospective study aims to evaluate the association of serum BPA levels with chronic kidney disease (CKD) in a Chinese middle-aged and elderly population. At baseline 1370 participants (mean age 61.7 years, 58.8% females) free of kidney disease and cancer were followed up nearly 10 years. Baseline serum BPA concentration was measured with high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS). Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Multivariable logistic regression model was used to investigate relationship between serum BPA levels and incident CKD risk. During a 10-year follow-up, 246 individuals developed CKD. Baseline serum BPA concentration was 2.92 (1.00, 5.27) ng/mL. At baseline, after adjustment for multiple covariates serum BPA levels were negatively correlated with eGFR levels (β = -0.068, P = 0.009). Compared to those with low levels of serum BPA, participants with high levels had a significant negative association with CKD [ORs (95% CI) = 0.35 (0.25, 0.50), P < 0.001], and this association was not modified by conventional risk factors. The negative associations remained in females but not in males (P for interaction = 0.016). Significant interaction between baseline eGFR and serum BPA levels on CKD risk was also found (P for interaction = 0.027), Except subjects with 60-70 mL/min/1.73 m² eGFR at baseline, inverse association robustly existed between serum BPA levels and incident CKD risk in the other eGFR subgroups. Further studies are needed to validate our findings.

Near real-time analysis of para-cresol in wastewater with a laccase-carbon nanotube-based biosensor

Para-Cresol is a water-soluble organic pollutant, which is harmful to organisms even at low concentrations. Therefore, it is important to rapidly detect the p-cresol in wastewater as well as natural water. In this work, a new, simple and stable biosensor was developed for on-site quantitatively determination and near real-time monitoring p-cresol in wastewater. The new biosensor was designed and fabricated using a screen-printed carbon electrode (SPCE) modified by waste-derived carbon nanotubes (CNTs) immobilized with laccase (LAC). The fabrication processes and performance of the biosensors were systematically characterized and optimized by Fourier transform infrared spectroscopy (FTIR), field emission scanning electron microscope (FESEM), transmission electron microscopy (TEM) and electrochemical methods. With improved conductivity, the proposed biosensor could provide the direct quantitation of p-cresol. The linear range of the biosensor is 0.2-25 ppm of p-cresol with a detection limit of 0.05 ppm. Additionally, the biosensor exhibited high reproducibility, stability and reusability during the validation. More importantly, the biosensor was successfully applied for the rapid detection of p-cresol in environmental lab wastewater under the interference of metal ions and other organics, and the results were consistent with high-performance liquid chromatography (HPLC). Finally, the biosensor with a portable potentiostat was approved as an easy-to-use, sensitive and inexpensive platform that could provide near real-time monitoring of p-cresol concentration in wastewater during Fenton oxidation treatment process.

Bisphenol A impaired cell adhesion by altering the expression of adhesion and cytoskeleton proteins on human podocytes

Bisphenol A (BPA), a chemical -xenoestrogen- used in food containers is present in the urine of almost the entire population. Recently, several extensive population studies have proven a significant association between urinary excretion of BPA and albuminuria. The alteration of glomerular podocytes or "podocytopathy" is a common event in chronic albuminuric conditions. Since many podocytes recovered from patients' urine are viable, we hypothesized that BPA could impair podocyte adhesion capabilities. Using an in vitro adhesion assay, we observed that BPA impaired podocyte adhesion, an effect that was abrogated by Tamoxifen (an estrogen receptor blocker). Genomic and proteomic analyses revealed that BPA affected the expression of several podocyte cytoskeleton and adhesion proteins. Western blot and immunocytochemistry confirmed the alteration in the protein expression of tubulin, vimentin, podocin, cofilin-1, vinculin, E-cadherin, nephrin, VCAM-1, tenascin-C, and β-catenin. Moreover, we also found that BPA, while decreased podocyte nitric oxide production, it lead to overproduction of ion superoxide. In conclusion, our data show that BPA induced a novel type of podocytopathy characterizes by an impairment of podocyte adhesion, by altering the expression of adhesion and cytoskeleton proteins. Moreover, BPA diminished production of podocyte nitric oxide and induced the overproduction of oxygen-free metabolites. These data provide a mechanism by which BPA could participate in the pathogenesis and progression of renal diseases.

Serially assessed bisphenol A and phthalate exposure and association with kidney function in children with chronic kidney disease in the US and Canada: A longitudinal cohort study

BACKGROUND

Exposure to environmental chemicals may be a modifiable risk factor for progression of chronic kidney disease (CKD). The purpose of this study was to examine the impact of serially assessed exposure to bisphenol A (BPA) and phthalates on measures of kidney function, tubular injury, and oxidative stress over time in a cohort of children with CKD.

METHODS AND FINDINGS

Samples were collected between 2005 and 2015 from 618 children and adolescents enrolled in the Chronic Kidney Disease in Children study, an observational cohort study of pediatric CKD patients from the US and Canada. Most study participants were male (63.8%) and white (58.3%), and participants had a median age of 11.0 years (interquartile range 7.6 to 14.6) at the baseline visit. In urine samples collected serially over an average of 3.0 years (standard deviation [SD] 1.6), concentrations of BPA, phthalic acid (PA), and phthalate metabolites were measured as well as biomarkers of tubular injury (kidney injury molecule-1 [KIM-1] and neutrophil gelatinase-associated lipocalin [NGAL]) and oxidative stress (8-hydroxy-2'-deoxyguanosine [8-OHdG] and F2-isoprostane). Clinical renal function measures included estimated glomerular filtration rate (eGFR), proteinuria, and blood pressure. Linear mixed models were fit to estimate the associations between urinary concentrations of 6 chemical exposure measures (i.e., BPA, PA, and 4 phthalate metabolite groups) and clinical renal outcomes and urinary concentrations of KIM-1, NGAL, 8-OHdG, and F2-isoprostane controlling for sex, age, race/ethnicity, glomerular status, birth weight, premature birth, angiotensin-converting enzyme inhibitor use, angiotensin receptor blocker use, BMI z-score for age and sex, and urinary creatinine. Urinary concentrations of BPA, PA, and phthalate metabolites were positively associated with urinary KIM-1, NGAL, 8-OHdG, and F2-isoprostane levels over time. For example, a 1-SD increase in ∑di-n-octyl phthalate metabolites was associated with increases in NGAL (β = 0.13 [95% CI: 0.05, 0.21], p = 0.001), KIM-1 (β = 0.30 [95% CI: 0.21, 0.40], p < 0.001), 8-OHdG (β = 0.10 [95% CI: 0.06, 0.13], p < 0.001), and F2-isoprostane (β = 0.13 [95% CI: 0.01, 0.25], p = 0.04) over time. BPA and phthalate metabolites were not associated with eGFR, proteinuria, or blood pressure, but PA was associated with lower eGFR over time. For a 1-SD increase in ln-transformed PA, there was an average decrease in eGFR of 0.38 ml/min/1.73 m2 (95% CI: -0.75, -0.01; p = 0.04). Limitations of this study included utilization of spot urine samples for exposure assessment of non-persistent compounds and lack of specific information on potential sources of exposure.

CONCLUSIONS

Although BPA and phthalate metabolites were not associated with clinical renal endpoints such as eGFR or proteinuria, there was a consistent pattern of increased tubular injury and oxidative stress over time, which have been shown to affect renal function in the long term. This raises concerns about the potential for clinically significant changes in renal function in relation to exposure to common environmental toxicants at current levels.

Neurochemical characterization of the enteric neurons within the porcine jejunum in physiological conditions and under the influence of bisphenol A (BPA)

BACKGROUND

Bisphenol A (BPA) is commonly used in the production of plastics and has multidirectional, negative effects on the living organisms. It may also affect the enteric nervous system (ENS) located in the wall of the gastrointestinal tract. Enteric neurons express many active substances, which regulate majority of intestinal activities not only in physiological conditions but also under the impact of pathological factors.

METHODS

The influence of various doses of BPA on the ENS of jejunum has been investigated using the double immunofluorescence technique. The commercial antibodies against substance P (SP), vasoactive intestinal polypeptide (VIP), galanin (GAL), vesicular acetylcholine transporter (VAChT), and cocaine- and amphetamine-regulated transcript peptide (CART) were used.

KEY RESULTS

Both doses of BPA studied changed the number of the enteric neurons immunoreactive to SP, VIP, GAL, VAChT, and CART, and the intensity of fluctuations depended on the BPA dose and on the type of the enteric plexus. Bisphenol A causes the increase in the number of neurons immunoreactive to the majority of substances studied. The only exception was VAChT-positive neurons, the number of which was lower under the impact of BPA in the comparison with physiological conditions.

CONCLUSIONS & INFERENCES

Even low doses of BPA cause the changes in neurochemical characterization of the enteric neurons in the jejunum. These changes may be the first sign of subclinical BPA intoxication. The mechanisms of observed changes are probably connected with neurotoxic and/or pro-inflammatory activity of BPA, but their exact mechanisms are not fully explained.

The ameliorative effect of quercetin on bisphenol A-induced toxicity in mitochondria isolated from rats

Recent studies have demonstrated that bisphenol A (BPA) has an adverse or toxic effect on the kidney. This study was designed to evaluate the ability of quercetin (QUER) to prevent BPA-induced mitochondrial dysfunction. Thirty-two healthy adult male Wistar rats were randomly divided into four groups, as follows: control group (olive oil), BPA group (250 mg/kg), BPA þ QUER group (250 mg/kg + 75 mg/kg), and QUER group (75 mg/kg). All treatments were orally administered for 14 days. Kidney mitochondria were isolated by administration of the different centrifugation method. Uric acid and creatinine were considered to be biomarkers of nephrotoxicity. The ameliorative effects of QUER on BPA toxicity were evaluated by determining the glutathione (GSH) content, CAT, the damage to the mitochondrial membrane, the reactive oxygen species (ROS), and lipid peroxidation (LPO). Administration of BPA significantly decreased kidney weight. In the kidney, BPA can deplete GSH content and CAT activity, increase the mitochondrial ROS formation, and enhances LPO and mitochondrial membrane damage. The pretreatment of mitochondria with QUER has the ability to reduce the toxic effects of BPA in isolated mitochondria. These findings suggest a potential role for QUER in protecting mitochondria from oxidative damage in kidney tissue.

Influence of dialysis membrane composition on plasma bisphenol A levels during online hemodiafiltration

Introduction

Bisphenol A (BPA) is an ubiquitous environmental toxin that is also found in dialyzers. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, the BPA contents of dialysis membranes may be a source of BPA loading during OL-HDF.

Methods

A prospective study assessed plasma BPA levels in OL-HDF patients using BPA-free (polynephron) or BPA-containing (polysulfone) dialyzers in a crossover design with two arms, after a run-in OL-HDF period of at least 6 months with the same membrane: 31 patients on polynephron at baseline were switched to polysulfone membranes for 3 months (polynephron-to-polysulfone) and 29 patients on polysulfone were switched to polynephron for 3 months (polysulfone-to-polynephron).

Results

After a run-in OL-HDF period of at least 6 months with the same membrane, baseline pre-dialysis BPA was lower in patients on polynephron (8.79±7.97 ng/ml) than in those on polysulfone (23.42±20.38 ng/mL, p<0.01), but still higher than in healthy controls (<2 ng/mL). After 3 months of polynephron-to-polysulfone switch, BPA was unchanged (8.98±7.88 to 11.14±15.98 ng/mL, ns) while it decreased on the polysulfone-to-polynephron group (23.42±20.38 to 11.41±12.38 ng/mL, p<0.01).

Conclusion

OL-HDF for 3 months with BPA-free dialyzer membranes was associated to a significant decrease in predialysis BPA levels when compared to baseline BPA levels while on a BPA-containing membrane.

Protective effects of Asparagus officinalis extract against Bisphenol A- induced toxicity in Wistar rats

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1 Bisphenol A treatment lead to histopathologic changes in liver and kidney tissues.

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2- Bisphenol A decreased the antioxidant capacities in rats.

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3- Asparagus officinalis alleviate the extent of oxidative status induced by BPA.

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3- Asparagus officinalis decreases the pathological change of liver and kidney caused by BPA.

Asparagus officinalis is an herbal medicine with remarkable antioxidant, anti-inflammatory, and antihepatotoxic properties. The present study aimed to investigate whether Bisphenol A (BPA) could induce histopathological changes and oxidative stress in the liver and kidney tissues of male rats. In addition, we evaluated whether the co-administration of the Asparagus officinalis extract (AOE) could prevent the possible damages. In total, 40 adult male Wistar rats with the mean weight of 200 ± 20 grams were divided into five groups. Control subjects were placed in the first group, while group two was the vehicle (5 ml/kg bwt/day). Subjects in group three were administered with 400 mg/kg of AOE (bwt/day), group four received 10 mg/kg of BPA (bwt/day) dissolved in 5 ml/kg of olive oil, and group five received oral BPA and AOE daily for eight weeks. After the experiments, the blood, liver, and kidneys of the animals were collected and examined. Biochemical results showed a significant elevation in the levels of liver and kidney biomarkers in the BPA group (P ≤ 0.05). Moreover, malondialdehyde was observed to increase, while thiol protein and total antioxidant capacity decreased. Histopathological results of the BPA group indicated dilated and congested central and portal veins and inflammatory areas in the liver. In addition, renal test results showed casts in the urinary tubules and acute tubular necrosis. According to the results, the co-administration of AOE and BPA could increase the total antioxidative capability, thereby improving the function and structure of the liver and kidney tissues. Therefore, AOE is a potential protective agent against oxidative stress, liver, and kidney damage.

Bisphenol A is an exogenous toxin that promotes mitochondrial injury and death in tubular cells

BACKGROUND

Uremic toxins that accumulate in chronic kidney disease (CKD) contribute to CKD complications, such as CKD progression. Bisphenol A (BPA) is a ubiquitous environmental toxin, structurally related with p-cresol, that accumulates in CKD. Our aim was to characterize the nephrotoxic potential of BPA. Specifically, we addressed BPA toxicity over energy-demanding proximal tubular cells.

METHODS

Cell death and oxidative stress were evaluated by flow cytometry and confocal microscopy in HK-2 human proximal tubular epithelial cells. Functional assays tested ATP, intracellular Ca²⁺ , mitochondrial function (tetramethylrhodamine methyl [TMRM]), oxygen consumption, Nrf2-binding, MitoSOX, and NADPH oxidase activity. Gene expression was assessed by qRT-PCR.

RESULTS

Following acute exposure (24 hours), proximal tubular cell viability was decreased by BPA concentrations ≥50 μM while a seven-day exposure resulted in a progressive loss of cell viability at a nanomolar range. Within 24 hours, BPA promoted mitochondrial dysfunction leading to energy depletion and increased mitochondrial and cytoplasmic oxidative stress and apoptosis in a concentration-dependent manner. An antioxidant response was observed manifested by nuclear Nrf2 translocation and increased expression of the Nrf2 target genes Heme oxygenase 1 (HO-1) and NAD(P)H dehydrogenase [quinone] 1 (NQO-1).

CONCLUSIONS

This study demonstrates for the first time that BPA causes mitochondrial injury, oxidative stress and apoptotic death in tubular cells. These results characterize BPA as an exogenous toxin that, similar to uremic toxins, may contribute to CKD progression.

Renal and hepatic effects following neonatal exposure to low doses of Bisphenol-A and 137Cs

137-Cesium (¹³⁷Cs) is one of the most important distributed radionuclides after a nuclear accident. Humans are usually co-exposed to various environmental toxicants, being Bisphenol-A (BPA) one of them. Exposure to IR and BPA in early life is of major concern, due to the higher vulnerability of developing organs. We evaluate the renal and hepatic effects of low doses of ionizing radiation (IR) and BPA. Sixty male mice (C57BL/6J) were randomly assigned to six experimental groups (n=10) and received a single subcutaneous dose of 0.9% saline solution, ¹³⁷Cs and/or BPA on postnatal day 10: control, BPA (25 μg/kgbw), Cs4000 (4000 Bq ¹³⁷Cs/kgbw), Cs8000 (8000 Bq ¹³⁷Cs/kgbw), BPA/Cs4000 and BPA/Cs8000. At the age of two months, urines (24h) and blood samples were collected from animals of each group to determine biochemical parameters. Finally, kidneys and liver were removed to quantify DNA damage (8-OHdG), as well as to determine CYP1A2 mRNA expression. Data suggest that both BPA and ¹³⁷Cs induced renal and liver damage evidenced by oxidative stress. However, when there is a co-exposure, it seems that there are compensatory mechanisms that may reverse the damage induced by each toxic itself. Notwithstanding, more studies are necessary to better understand the synergistic mechanisms behind.

DNA damage in kidney transplant patients. Role of organ origin

Chronic kidney disease (CKD) patients are characterized by elevated levels of genomic damage. This damage increases when kidney function decreases being maximum in hemodialysis patients. As kidney transplantation improves renal function, and it is related with better survival, the aim of our study was to evaluate potential changes in DNA damage levels after kidney transplantation, and comparing living donor recipients with cadaveric donor recipients. The alkaline comet assay was used to determine DNA breaks and oxidative damaged DNA; and the micronucleus assay was used to determine chromosomal breakage and/or aneuploidy. Fifty CKD patients were followed up after 6 and 12 months of their kidney transplantation. All patients increased their genomic damage levels after 6 and 12 months of renal transplantation, compared with those observed before transplantation, despite of the improvement of their metabolic functions. Donor advanced age correlated positively with higher DNA damage. Genomic damage was lower in living donor transplants with respect to cadaveric donor transplants. Our conclusion is that DNA damage increased in kidney transplantation patients, whereas their renal function improved. Higher levels of DNA damage were found in cadaveric donor transplants when compared to living donor transplants. Environ. Mol. Mutagen. 58:712-718, 2017. © 2017 Wiley Periodicals, Inc.

Asymmetric triacetate membrane keeps high water flux during ultrafiltration: in vitro study

Membrane fouling is a primary challenge encountered during the administration of hemodialysis (HD) and hemodiafiltration (HDF). A high-flux membrane is suitable for dialyzer reuse, since it is used repeatedly. Water flux is a benchmark used to assess the effectiveness of the dialysis membrane during treatment and it is usually evaluated to determine whether membrane fouling has occurred. Polysulfone (PS) membrane has good biocompatibility and solute permeability; however, polyethersulfone (PES) is often used as a hemodiafilter membrane because of better hydrophilicity compared to PS. We evaluated water flux across hemodiafilters using newly developed asymmetric triacetate (ATA) and PES as conventional membranes in vitro. Water flux of across ATA and PES membranes significantly decreased 30 min after the start of the experiments and thereafter showed stabilization. Water flux across the ATA membrane consistently showed significantly higher values of greater than 100 mL/m²/h/mmHg, compared to lower values observed across the PES membrane. These results suggest that the ATA membrane has a potential use not only for HDF, but also for long-time therapies of HD and HDF.

Nutrients Turned into Toxins: Microbiota Modulation of Nutrient Properties in Chronic Kidney Disease

In chronic kidney disease (CKD), accumulation of uremic toxins is associated with an increased risk of death. Some uremic toxins are ingested with the diet, such as phosphate and star fruit-derived caramboxin. Others result from nutrient processing by gut microbiota, yielding precursors of uremic toxins or uremic toxins themselves. These nutrients include l-carnitine, choline/phosphatidylcholine, tryptophan and tyrosine, which are also sold over-the-counter as nutritional supplements. Physicians and patients alike should be aware that, in CKD patients, the use of these supplements may lead to potentially toxic effects. Unfortunately, most patients with CKD are not aware of their condition. Some of the dietary components may modify the gut microbiota, increasing the number of bacteria that process them to yield uremic toxins, such as trimethylamine N-Oxide (TMAO), p-cresyl sulfate, indoxyl sulfate and indole-3 acetic acid. Circulating levels of nutrient-derived uremic toxins are associated to increased risk of death and cardiovascular disease and there is evidence that this association may be causal. Future developments may include maneuvers to modify gut processing or absorption of these nutrients or derivatives to improve CKD patient outcomes.

Online Hemodiafiltration Reduces Bisphenol A Levels

Several uremic toxins have been identified and related to higher rates of morbidity and mortality in dialysis patients. Bisphenol A (BPA) accumulates in patients with chronic kidney disease. The aim of this study is to demonstrate the usefulness of online hemodiafiltration (OL-HDF) in reducing BPA levels. Thirty stable hemodialysis patients were selected to participate in this paired study. During three periods of 3 weeks each, patients were switched from high-flux hemodialysis (HF-HD) to OL-HDF, and back to HF-HD. BPA levels were measured in the last session of each period (pre- and post-dialysis) using ELISA and HPLC. Twenty-two patients (mean age 73 ± 14 years; 86.4% males) were included. Measurements of BPA levels by HPLC and ELISA assays showed a weak but significant correlation (r = 0.218, P = 0.012). BPA levels decreased in the OL-HDF period of hemodialysis, in contrast to the HF-HD period when they remained stable (P = 0.002). In conclusion, OL-HDF reduced BPA levels in dialysis patients.

Recent advances in simultaneous analysis of bisphenol A and its conjugates in human matrices: Exposure biomarker perspectives

Human exposures to bisphenol A (BPA) has attained considerable global health attention and represents one of the leading environmental contaminants with potential adverse health effects including endocrine disruption. Current practice of measuring of exposure to BPA includes the measurement of unconjugated BPA (aglycone) and total (both conjugated and unconjugated) BPA; the difference between the two measurements leads to estimation of conjugated forms. However, the measurement of BPA as the end analyte leads to inaccurate estimates from potential interferences from background sources during sample collection and analysis. BPA glucuronides (BPAG) and sulfates (BPAS) represent better candidates for biomarkers of BPA exposure, since they require in vivo metabolism and are not prone to external contamination. In this work, the primary focus was to review the current state of the art in analytical methods available to quantitate BPA conjugates. The entire analytical procedure for the simultaneous extraction and detection of aglycone BPA and conjugates is covered, from sample pre-treatment, extraction, separation, ionization, and detection. Solid phase extraction coupled with liquid chromatograph and tandem mass spectrometer analysis provides the most sensitive detection and quantification of BPA conjugates. Discussed herein are the applications of BPA conjugates analysis in human exposure assessment studies. Measuring these potential biomarkers of BPA exposure has only recently become analytically feasible and there are limitations and challenges to overcome in biomonitoring studies.

Serum bisphenol A as a predictor of chronic kidney disease progression in primary hypertension: a 6-year prospective study

OBJECTIVE

Hypertensive nephropathy is one of the major causes of chronic kidney disease (CKD). Bisphenol A (BPA) is associated with elevated blood pressure and urinary albuminuria. The aim of this study is to evaluate the association between serum BPA with the progression of CKD in patients with primary hypertension.

METHODS

In this prospective study, 302 patients with primary hypertension were followed up for 6 years (195 men and 107 women, 65.29 ± 9.78 years at baseline). The baseline values of serum BPA were measured. Renal function was measured as estimated glomerular filtration rate (eGFR) calculated by the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation (eGFRcr-cys). Regression models were used to calculate associations of serum BPA with the annual change in eGFR and the risk of CKD progression.

RESULTS

Baseline serum BPA concentration was 0.61(0.26, 2.44) ng/ml and was significantly negatively correlated with the annual change in eGFR (R = -0.197, P < 0.001). After adjusting for clinical factors, baseline serum BPA level had a significant negative association with the annual change in eGFR (β = -0.132, P = 0.007). Univariate logistic regression analysis showed that the baseline age, SBP, eGFR, and serum BPA levels were predictors of CKD stage 3 or greater. In multivariate logistic regression analysis, patients with high serum BPA levels exhibited a five-fold increased risk of developing CKD stage 3 or greater compared with patients with low serum BPA levels [odds ratio 4.79 (95% confidence interval 1.81, 14.25), P = 0.004].

CONCLUSION

Serum BPA may be a predictor of CKD progression in patients with primary hypertension.

Serum bisphenol A and progression of type 2 diabetic nephropathy: a 6-year prospective study

AIMS

Bisphenol A (BPA) is associated with diabetes and cardiovascular diseases. The aim of our study was to evaluate whether serum BPA could predict the progression of chronic kidney disease (CKD) in patients with type 2 diabetes (T2D).

METHODS

In this prospective study, a total of 121 patients with T2D and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m(2) were followed up for 6 years. The baseline values of serum BPA were measured. Renal function was measured as eGFR calculated by the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation. Development of CKD was defined as eGFR < 60 mL/min/1.73 m(2) at the last follow-up. Regression models were used to analyze the associations of serum BPA with the change in eGFR and the risk of CKD development.

RESULTS

Baseline serum BPA concentration was 0.40 (0.17, 1.40) ng/mL. Duration of T2D, baseline waist circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, and serum BPA level were significantly negatively associated with the annual change and percentage change in eGFR. After adjusting for clinical factors, baseline serum BPA level had a significant negative association with the annual change in eGFR (β = -0.371, P < 0.001) and percentage change in eGFR (β = -0.391, P = <0.001). Multivariate logistic regression analysis showed that patients with high levels of serum BPA exhibited about a sevenfold increased risk of developing CKD compared to patients with low levels of serum BPA [odds ratio (OR) 6.65 (95 % CI 1.47, 30.04), P = 0.014].

CONCLUSION

Serum BPA may be a predictor of CKD in patients with T2D.

The Choice of Hemodialysis Membrane Affects Bisphenol A Levels in Blood

Bisphenol A (BPA), a component of some dialysis membranes, accumulates in CKD. Observational studies have linked BPA exposure to kidney and cardiovascular injury in humans, and animal studies have described a causative link. Normal kidneys rapidly excrete BPA, but insufficient excretion may sensitize patients with CKD to adverse the effects of BPA. Using a crossover design, we studied the effect of dialysis with BPA-containing polysulfone or BPA-free polynephron dialyzers on BPA levels in 69 prevalent patients on hemodialysis: 28 patients started on polysulfone dialyzers and were switched to polynephron dialyzers; 41 patients started on polynephron dialyzers and were switched to polysulfone dialyzers. Results were grouped for analysis. Mean BPA levels increased after one hemodialysis session with polysulfone dialyzers but not with polynephron dialyzers. Chronic (3-month) use of polysulfone dialyzers did not significantly increase predialysis serum BPA levels, although a trend toward increase was detected (from 48.8±6.8 to 69.1±10.1 ng/ml). Chronic use of polynephron dialyzers reduced predialysis serum BPA (from 70.6±8.4 to 47.1±7.5 ng/ml, P<0.05). Intracellular BPA in PBMCs increased after chronic hemodialysis with polysulfone dialyzers (from 0.039±0.002 to 0.043±0.001 ng/10(6) cells, P<0.01), but decreased with polynephron dialyzers (from 0.045±0.001 to 0.036±0.001 ng/10(6) cells, P<0.01). Furthermore, chronic hemodialysis with polysulfone dialyzers increased oxidative stress in PBMCs and inflammatory marker concentrations in circulation. In vitro, polysulfone membranes released significantly more BPA into the culture medium and induced more cytokine production in cultured PBMCs than did polynephron membranes. In conclusion, dialyzer BPA content may contribute to BPA burden in patients on hemodialysis.

Bisphenol-A induces podocytopathy with proteinuria in mice

Bisphenol-A, a chemical used in the production of the plastic lining of food and beverage containers, can be found in significant levels in human fluids. Recently, bisphenol-A has been associated with low-grade albuminuria in adults as well as in children. Since glomerular epithelial cells (podocytes) are commonly affected in proteinuric conditions, herein we explored the effects of bisphenol-A on podocytes in vitro and in vivo. On cultured podocytes we first observed that bisphenol-A-at low or high concentrations-(10 nM and 100 nM, respectively) was able to induce hypertrophy, diminish viability, and promote apoptosis. We also found an increase in the protein expression of TGF-β1 and its receptor, the cyclin-dependent kinase inhibitor p27Kip1, as well as collagen-IV, while observing a diminished expression of the slit diaphragm proteins nephrin and podocin. Furthermore, mice intraperitoneally injected with bisphenol-A (50 mg/Kg for 5 weeks) displayed an increase in urinary albumin excretion and endogenous creatinine clearance. Renal histology showed mesangial expansion. At ultrastructural level, podocytes displayed an enlargement of both cytoplasm and foot processes as well as the presence of condensed chromatin, suggesting apoptosis. Furthermore, immunohistochemistry for WT-1 (specific podocyte marker) and the TUNEL technique showed podocytopenia as well as the presence of apoptosis, respectively. In conclusion, our data demonstrate that Bisphenol-A exposure promotes a podocytopathy with proteinuria, glomerular hyperfiltration and podocytopenia. Further studies are needed to clarify the potential role of bisphenol-A in the pathogenesis as well as in the progression of renal diseases.