Association of indoor use of pesticides with CKD of unknown origin

Diabetes mellitus and hypertension are the two main etiologies of chronic kidney disease (CKD). However, CKD subjects of unknown origin (CKDu) have been recognized recently. One of the proposed causes is pesticide use in farmers. On the other hand, house use of pesticides has never been investigated in developing countries. In this study, we aimed to investigate the association between house use of pesticide and their exposure time with CKDu. This study is part of the population-based cohort of Prospective Epidemiological Research Studies in Iran. We used the baseline data of the Zahedan Adult Cohort Study. We dropped all subjects with diabetes mellitus and/ or hypertension, egfr 60-89 ml/min/1.73 m2, and unavailable creatinine measurement. Subjects with egfr of less than 60 ml/min/1.73 m2 through MDRD equations were defined as CKDu and compared with subjects with egfr of more than 90 ml/min/1.73 m2. The house use of pesticides and exposure time were asked through a questionnaire. In this study 10072 participants enrolled, and 1079 remained in the final sample after appliance the exclusion criteria. Female sex, single marital status, low physical activity, TG more than 150 mg/dl, BMI of more than 25, non-smokers, house use of pesticide, and more time exposed to pesticides were associated with CKDu. The effects of age, female sex, TG more than 150 mg/dl, pesticide use (1.36;95%CI 1.01-1.84), and the third tertile of exposure time compared to non-users (1.64;95%CI 1.07-2.51) remained significant in multivariable analysis. We found a positive association between the use and exposure time with kidney function in cases without diabetes mellitus and hypertension. Further longitudinal studies should be carried out to assess this effect. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by Zahedan University of Medical Sciences (Grant number: 93-4-96451). The Iranian Ministry of Health and Medical Education has also contributed to the funding used in the PERSIAN Cohort through Grant no. 700/152 and 700/534. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the ethics committee Zahedan University of Medical Sciences as the main executive university with the approval number of IR.ZAUMS.REC.1401.160. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data cannot be shared publicly because of sensitive information. Data are available from the TUMS In Ethics Committee (contact via email of corresponding author) for researchers who meet the criteria for access to confidential data.