Chronic kidney disease is a growing problem worldwide and among the aging US population. But could the foundations for this progressing disease have been laid while the victims were still in the womb?
Newly launched research at the University of Pittsburgh School of Public Health seeks to determine whether pregnant mothers’ exposure to toxic metals affects their babies’ kidney development, paving the way for a problem that won’t become apparent until the baby is an adult is.
The National Institutes of Health recently awarded a three-year, $2.2 million “high risk, high reward” grant to Dr. Alison Sanders, an assistant professor in Pitt’s Department of Environmental and Occupational Health, to assemble a transdisciplinary team of scientists who will collect data and examine the hypothesis from multiple angles.
Over the past two decades, much research has been done on a range of conditions, from cardiovascular to behavioral, to exposure to toxic metals in the womb. But we think of chronic kidney disease as a late-stage adult disease, so it hasn’t received the same attention. That is starting to change.”
Dr. Alison Sanders, assistant professor, Pitt’s Department of Environmental and Occupational Health
According to the International Society of Nephrology, it is estimated that more than 10% of the world’s population – at least 800 million people – suffer from chronic kidney disease, and the number is growing. It happens when the kidneys don’t filter the blood properly and eventually leads to kidney failure, requiring dialysis or a transplant.
Diabetes, high blood pressure, heart disease and family history are the main risk factors for developing chronic kidney disease, but some people develop chronic kidney disease of unknown origin.
“It’s a type of kidney disease that occurs in younger people and is characterized by a more rapid decline in kidney function,” Sanders said. “People go from diagnosis to death in 10 years.”
Sanders suspects that there are certain times during fetal development when minor exposure to toxic metals and metalloids, such as arsenic, cadmium, lead and mercury, can have profound effects on the growing kidney by reducing the number of functional filtering units in the resulting organ. Reduce. Heat stress from a warming world may then be enough to cause these lower-quality kidneys to fail, she explained.
For the NIH project, part of the National Institute of Environmental Health Sciences’ Superfund research portfolio, Sanders has brought together a team of epidemiologists, biostatisticians, engineers, toxicologists, risk assessors and nephrologists to compile global data on the mix of toxic metals. to research. measured in the blood and urine of women of childbearing age and pregnant mothers. They then look at the effects of these metal mixtures on kidney development using fish, mouse and human-derived organoid models. The team consists of Dr. Neil Hukriede and Dr. Jacqueline Ho, both of Pitt, Dr. Nishad Jayasundara from Duke University and Dr. Chris Gennings of the Icahn School of Medicine at Mount Sinai.
“By itself, each metal may not be at high enough levels to be of concern, but there may be a combination of low levels of many metals that amplify their harmful effects,” Sanders said.
Different geographic regions are known for the likelihood of finding different combinations of metals in human samples. For example, coastal areas may have populations with more mercury and cadmium because they are concentrated in seafood, while arsenic is more likely to be found in populations that drink from groundwater sources.
By gaining information on whether a particular mix of toxic metals is more harmful to the kidneys of a developing fetus, and whether there are geographic areas where these metals are more likely to be found – especially if those areas are hit harder by climate change – Sanders hopes that her team can inform policymakers and raise public awareness of their risks.
“We don’t have a lot of regulatory guidance on what levels are dangerous when it comes to mixtures of toxic metals during pregnancy; we have guidelines for only lead, only mercury, but no combinations,” Sanders said. “If we find that a certain ratio or mixture of metals damages developing kidneys, that could support policies that protect pregnant mothers and their babies.”
On June 5 at the Pitt School of Public Health, Sanders and her scientific team will present the Environmental Health Kidney Symposium. Details are available by registering for the event. In addition, people interested in contributing to the study can contact Sanders at [email protected]
“Our team wants to broaden our transdisciplinary approach,” said Sanders. “We hope the symposium will encourage people with ideas to attend and get in touch.”