Synergistic impact of co-exposures to toxic metals cadmium, lead, and mercury along with perfluoroalkyl substances on the healthy kidney function.

Impact of co-exposures to toxic metals cadmium, lead, and mercury along with perfluoroalkyl substances on the healthy kidney function was evaluated among US adults aged > = 20 years by analyzing data (N = 7857) from National Health and Nutrition Examination Survey for 2003-2014. Perfluoroalkyl substances selected for analysis were: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). High levels of exposures to Cd, Pb, total Hg, and PFAS were said to occur if their observed levels in blood/serum were greater than 75th percentiles. A healthy kidney function was defined if estimated glomerular filtration rate was found to be > = 60 mL/min/1.73 m2 and urine albumin creatinine ratio was ≤ 30 mg/g creatinine. Adjusted odds of a healthy kidney function due to co-exposures to high levels of Cd along with high levels of PFOA, PFOS, and PFNA were found to be 0.713, 0.576, and 0.640 respectively. Adjusted odds of a healthy kidney function due to co-exposures to high levels of Pb along with high levels of PFOA, and PFNA were found to be 0.657, and 0.671 respectively. Co-exposures to high levels of Hg as measured by the total mercury in blood was not found to affect the odds of a healthy kidney function.