Polyfluoroalkyl chemicals and the risk of kidney stones in US adults: A population-based study

The potential nephrotoxicity of polyfluoroalkyl chemicals (PFCs) have received extensive attention. However, the relationship between PFCs and the risk of kidney stones remain unclear. This study aimed to examine the level of PFCs in the US population and its relationship with the risk of kidney stones. We investigated the serum levels of six PFCs in 8453 adult participants (≥20 years) from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016, including perfluorodecanoic acid (PFDE), perfluorohexane sulfonic acid (PFHS), 2-(N-methyl-perfluorooctane sulfonamido) acetate (MPAH), perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFUA), and perfluorododecanoic acid (PFDO). Logistic regression model was used to evaluate the correlation between PFCs and kidney stones. Of the 8453 participants, 787 self-reported a history of kidney stones. After adjusting for gender, age, race, education, marital status, body mass index (BMI), hypertension, diabetes and estimated glomerular filtration rate (eGFR), we found that total PFCs and PFHS were positively correlated with the risk of kidney stones. Compared with the lowest tertile, the odds ratios with 95% confidence intervals (CI) with increasing tertiles were 1.30 (95% CI,1.08–1.59, p = 0.007) and 1.25 (95 CI%,1.00–1.52, p = 0.024) for total PFCs and 1.24 (95 CI%,1.03–1.51, p = 0.032), and 1.35 (95 CI,1.10–1.68, p = 0.005) for PFHS. Our study shows that total PFCs and PFHS were associated with an increased risk of kidney stones. [Display omitted] •We estimated the association of blood polyfluoroalkyl chemicals and the risk of kidney stones in US adults.•The concentration of total PFC, PFHS, MAPH and PFNA in patients with kidney stone formation is higher.•Total PFCs and PFHS were positively correlated with the risk of kidney stones.