Continuous Exposure to Environmental Endocrine Disruptors on the Prognosis of Children With Nephritis: An Observational Cohort Study

ABSTRACT Objective Explore the impact of partial urinary environmental endocrine disruptors (EEDs) on the pathogenesis and renal function in paediatric patients diagnosed with Henoch‐Schönlein purpura nephritis (HSPN). Methods This was an observational cohort study. Paediatric patients diagnosed with HSPN ( N = 41) and the children through routine physical examination ( N = 40). Nine detection indices for endocrine disruptors were identified using liquid chromatography. Results The levels of several EEDs from urine samples in the HSPN group were generally higher than those in the physical examination group. The Logistic regression analysis and Receiver Operating Characteristic (ROC) curve indicate that Benzo(a)pyrene, Mono‐(2‐ethylhexyl) phthalate (MEPH), Zearalenone, Lead and Bisphenol A (BPA) may have good screening capacity for predicting the pathogenesis of HSPN. The multivariable linear mixed effects (LME) models were used to estimate urine Lead concentrations, which are inversely associated with the Estimated Glomerular Filtration Rate (eGFR) among HSPN patients. Conversely, urine MEPH concentrations are associated with the Urine Albumin Creatine Ratio (UACR). However, only MEHP and BPA were associated with the prognosis grade of HSPN patients. Conclusions By comparing the abundance levels of endocrine disruptors in urine between healthy children and HSPN patients, we identified those differentially enriched in HSPN. Subsequently, we assessed the association of these differentially enriched disruptors with patient prognosis. The aggregation of five specific EEDs constitutes a latent aetiological factor predisposing paediatric cohorts to the manifestation of HSPN and may bear substantial repercussions for nephric prognostication.