Association between serum organophosphorus pesticides and the risk of incident chronic kidney disease: findings from Dongfeng-Tongji cohort

or positive urine protein. Multivariate logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). During a median follow-up of 5.16 years, 287 incident CKD cases were identified. Multivariate logistic regression models revealed that higher serum levels of methidathion (Q4 vs. Q1: OR = 1.61, 95% CI: 1.11-2.33) and ethion (Q4 vs. Q1: OR = 1.58, 95% CI: 1.09-2.30) were significantly associated with higher risk of CKD. Phorate and diazinon, analyzed as binary variables due to low detection rates (<50%), were also positively associated with CKD risk (OR = 1.41, 95% CI: 1.09-1.83; and OR = 1.37, 95% CI: 1.02-1.84, respectively). Moreover, significant multiplicative and additive interactions were observed between diazinon and fish/seafood consumption (≥5 times/week), with an attributable proportion due to interaction of 0.59 (95% CI: 0.25-0.94). These findings demonstrate that OPPs are significantly associated with incident CKD risk and identify a novel interaction between diazinon and dietary factors. This study supports the inclusion of serum OPPs compounds in the early biological monitoring system for CKD-susceptible populations and underscores the importance of environmental monitoring in disease prevention.