Acrolein exposure associated with kidney damage: a cross‑sectional study

Acrolein (Acr) is a common volatile toxic substance excreted by the kidneys. There are no studies that specifically look at the effects of Acr on kidney function. This study was designed to investigate the relationship between Acr and kidney damage. A cross-sectional study of data (n = 4951) from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) was conducted. Participants' urinary Acr concentration, estimated glomerular filtration rate (eGFR), and urinary albumin to creatinine ratio (UACR) were recorded based on laboratory tests. The number of participants with chronic kidney disease (CKD) was counted. Urinary Acr concentration was divided into quartiles. The association of urinary Acr with CKD and eGFR was investigated using multivariate linear regression, multivariate logistic regression, and smooth curve fitting. Subgroup analyses, interaction tests and sensitivity analyses were used to examine the independence of the Acr-CKD and Acr-eGFR associations in the population. In 4951 participants, urinary Acr concentration was positively associated with CKD risk and negatively associated with eGFR. In the fully adjusted model, each log₂Acr increase of one unit was associated with a 6% increased risk of CKD (OR = 1.06, 95% CI 1.01, 1.13) and a 0.54 mL/min/1.73 m² decrease in eGFR (β = - 0.54, 95% CI - 0.95, - 0.13). For categorical log₂Acr, for each log₂Acr increase of one unit, the risk of CKD was 29% higher in the Q4 group than in the Q1 group (OR = 1.29, 95% CI 1.01, 1.64), while eGFR was 1.9 mL/min/1.73 m² lower in the Q4 group than in the Q1 group (β = - 1.90, 95% CI - 3.65, - 0.14). Smooth curve fitting confirmed urinary Acr's nonlinear positive and negative correlations with CKD and eGFR. According to subgroup analyses, sensitivity analyses and interaction tests, the confounding variables did not affect the independent correlations of urinary Acr with CKD and eGFR. Our study found that Acr exposure was significantly associated with kidney damage. Our study provides a new piece of research evidence to support a link between the volatile toxic substance Acr and a decline in kidney function.