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Semin Nephrol. 2019 May;39(3):230-243. doi: 10.1016/j.semnephrol.2019.02.001.

Environmental and Occupational Exposures in Kidney Disease.

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Department of Environmental Health, Boston University School of Public Health, Boston, MA.
Division of Nephrology, New York University School of Medicine, New York, NY.
Division of Nephrology, New York University School of Medicine, New York, NY; Division of Nephrology, VA New York Harbor Healthcare System, New York, NY. Electronic address:


More than 8 million deaths each year are attributed to noncommunicable environmental hazards where people live, work, and play. Physical or chemical hazards may be inhaled, ingested, or absorbed through the skin, affecting all organ systems, including the kidney. Heavy metals, pesticides, and infections are some of the environmental hazards associated with kidney dysfunction and chronic kidney disease. The severity of the effects of these exposures likely is modulated by the timing and duration of exposure, genetic susceptibility, and other conditions, and may lead to the development of acute and/or chronic kidney disease. In this review, we discuss environmental exposures that are associated with kidney dysfunction in animals and human beings, with a focus on those implicated in causing chronic kidney disease.


Heavy metals; acute kidney injury; chronic kidney disease; environmental exposure; pesticides

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