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Association of indoor use of pesticides with CKD of unknown origin

Diabetes mellitus and hypertension are the two main etiologies of chronic kidney disease (CKD). However, CKD subjects of unknown origin (CKDu) have been recognized recently. One of the proposed causes is pesticide use in farmers. On the other hand, house use of pesticides has never been investigated in developing countries. In this study, we aimed to investigate the association between house use of pesticide and their exposure time with CKDu. This study is part of the population-based cohort of Prospective Epidemiological Research Studies in Iran. We used the baseline data of the Zahedan Adult Cohort Study. We dropped all subjects with diabetes mellitus and/ or hypertension, egfr 60-89 ml/min/1.73 m2, and unavailable creatinine measurement. Subjects with egfr of less than 60 ml/min/1.73 m2 through MDRD equations were defined as CKDu and compared with subjects with egfr of more than 90 ml/min/1.73 m2. The house use of pesticides and exposure time were asked through a questionnaire. In this study 10072 participants enrolled, and 1079 remained in the final sample after appliance the exclusion criteria. Female sex, single marital status, low physical activity, TG more than 150 mg/dl, BMI of more than 25, non-smokers, house use of pesticide, and more time exposed to pesticides were associated with CKDu. The effects of age, female sex, TG more than 150 mg/dl, pesticide use (1.36;95%CI 1.01-1.84), and the third tertile of exposure time compared to non-users (1.64;95%CI 1.07-2.51) remained significant in multivariable analysis. We found a positive association between the use and exposure time with kidney function in cases without diabetes mellitus and hypertension. Further longitudinal studies should be carried out to assess this effect.