Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health: A Scoping Review
Per- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants, the impact of PFAS exposure on human health is not well understood, and there are growing concerns for adverse effects on kidney function. Ther...
Saved in:
| Published in: | Clinical journal of the American Society of Nephrology Vol. 13; no. 10; p. 1479 |
|---|---|
| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
08.10.2018
|
| Subjects: | |
| ISSN: | 1555-905X, 1555-905X |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Per- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants, the impact of PFAS exposure on human health is not well understood, and there are growing concerns for adverse effects on kidney function. Therefore, we conducted a scoping review to summarize and identify gaps in the understanding between PFAS exposure and kidney health.
We systematically searched PubMed, EMBASE, EBSCO Global Health, World Health Organization Global Index, and Web of Science for studies published from 1990 to 2018. We included studies on the epidemiology, pharmacokinetics, or toxicology of PFAS exposure and kidney-related health, including clinical, histologic, molecular, and metabolic outcomes related to kidney disease, or outcomes related to the pharmacokinetic role of the kidneys.
We identified 74 studies, including 21 epidemiologic, 13 pharmacokinetic, and 40 toxicological studies. Three population-based epidemiologic studies demonstrated associations between PFAS exposure and lower kidney function. Along with toxicology studies (
=10) showing tubular histologic and cellular changes from PFAS exposure, pharmacokinetic studies (
=5) demonstrated the kidneys were major routes of elimination, with active proximal tubule transport. In several studies (
=17), PFAS exposure altered several pathways linked to kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2-related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.
A growing body of evidence portends PFASs are emerging environmental threats to kidney health; yet several important gaps in our understanding still exist. |
|---|---|
| AbstractList | Per- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants, the impact of PFAS exposure on human health is not well understood, and there are growing concerns for adverse effects on kidney function. Therefore, we conducted a scoping review to summarize and identify gaps in the understanding between PFAS exposure and kidney health.
We systematically searched PubMed, EMBASE, EBSCO Global Health, World Health Organization Global Index, and Web of Science for studies published from 1990 to 2018. We included studies on the epidemiology, pharmacokinetics, or toxicology of PFAS exposure and kidney-related health, including clinical, histologic, molecular, and metabolic outcomes related to kidney disease, or outcomes related to the pharmacokinetic role of the kidneys.
We identified 74 studies, including 21 epidemiologic, 13 pharmacokinetic, and 40 toxicological studies. Three population-based epidemiologic studies demonstrated associations between PFAS exposure and lower kidney function. Along with toxicology studies (
=10) showing tubular histologic and cellular changes from PFAS exposure, pharmacokinetic studies (
=5) demonstrated the kidneys were major routes of elimination, with active proximal tubule transport. In several studies (
=17), PFAS exposure altered several pathways linked to kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2-related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.
A growing body of evidence portends PFASs are emerging environmental threats to kidney health; yet several important gaps in our understanding still exist. Per- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants, the impact of PFAS exposure on human health is not well understood, and there are growing concerns for adverse effects on kidney function. Therefore, we conducted a scoping review to summarize and identify gaps in the understanding between PFAS exposure and kidney health.BACKGROUND AND OBJECTIVESPer- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants, the impact of PFAS exposure on human health is not well understood, and there are growing concerns for adverse effects on kidney function. Therefore, we conducted a scoping review to summarize and identify gaps in the understanding between PFAS exposure and kidney health.We systematically searched PubMed, EMBASE, EBSCO Global Health, World Health Organization Global Index, and Web of Science for studies published from 1990 to 2018. We included studies on the epidemiology, pharmacokinetics, or toxicology of PFAS exposure and kidney-related health, including clinical, histologic, molecular, and metabolic outcomes related to kidney disease, or outcomes related to the pharmacokinetic role of the kidneys.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTSWe systematically searched PubMed, EMBASE, EBSCO Global Health, World Health Organization Global Index, and Web of Science for studies published from 1990 to 2018. We included studies on the epidemiology, pharmacokinetics, or toxicology of PFAS exposure and kidney-related health, including clinical, histologic, molecular, and metabolic outcomes related to kidney disease, or outcomes related to the pharmacokinetic role of the kidneys.We identified 74 studies, including 21 epidemiologic, 13 pharmacokinetic, and 40 toxicological studies. Three population-based epidemiologic studies demonstrated associations between PFAS exposure and lower kidney function. Along with toxicology studies (n=10) showing tubular histologic and cellular changes from PFAS exposure, pharmacokinetic studies (n=5) demonstrated the kidneys were major routes of elimination, with active proximal tubule transport. In several studies (n=17), PFAS exposure altered several pathways linked to kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2-related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.RESULTSWe identified 74 studies, including 21 epidemiologic, 13 pharmacokinetic, and 40 toxicological studies. Three population-based epidemiologic studies demonstrated associations between PFAS exposure and lower kidney function. Along with toxicology studies (n=10) showing tubular histologic and cellular changes from PFAS exposure, pharmacokinetic studies (n=5) demonstrated the kidneys were major routes of elimination, with active proximal tubule transport. In several studies (n=17), PFAS exposure altered several pathways linked to kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2-related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.A growing body of evidence portends PFASs are emerging environmental threats to kidney health; yet several important gaps in our understanding still exist.CONCLUSIONSA growing body of evidence portends PFASs are emerging environmental threats to kidney health; yet several important gaps in our understanding still exist. |
| Author | Stapleton, Heather M Souma, Tomokazu Zhao, Xinlu Wittmer, Ashley Stanifer, John W Boulware, L Ebony |
| Author_xml | – sequence: 1 givenname: John W orcidid: 0000-0001-6379-300 surname: Stanifer fullname: Stanifer, John W organization: Duke Global Health Institute – sequence: 2 givenname: Heather M surname: Stapleton fullname: Stapleton, Heather M organization: Nicholas School of the Environment, and – sequence: 3 givenname: Tomokazu surname: Souma fullname: Souma, Tomokazu organization: Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; and – sequence: 4 givenname: Ashley surname: Wittmer fullname: Wittmer, Ashley organization: Duke Global Health Institute – sequence: 5 givenname: Xinlu surname: Zhao fullname: Zhao, Xinlu organization: Duke Global Health Institute – sequence: 6 givenname: L Ebony surname: Boulware fullname: Boulware, L Ebony organization: Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30213782$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkLtPwzAYxC1URB-wMSOPLCl-xHmwVVGhQAUIisSCIsf-0holTrGTov73BAES091wd9L9xmhgGwsInVIyZYyKi-z2fkrCKCYhTQ7QiAohgpSI18E_P0Rj798JCUPOxBEacsIojxM2Qm-P4Mqqa5yxsgWNsw3URsnKY-nxvAa3NnaN53ZnXGNrsK2s8GrjQLYetw2-M9rCHi9AVu3mEs_ws2q2340n2Bn4PEaHZb8FJ786QS9X81W2CJYP1zfZbBkoHkZtoKOwYAXjBac0BR3pQrKEE61KShTELIqpklRokvL-QhKrXnjCdEqiuNQsZBN0_rO7dc1HB77Na-MVVJW00HQ-Z5QIEtGeVx89-412RQ063zpTS7fP_5CwL-vQY5I |
| CitedBy_id | crossref_primary_10_1016_j_scitotenv_2022_154941 crossref_primary_10_1186_s12940_022_00857_9 crossref_primary_10_1016_j_microc_2020_105189 crossref_primary_10_3390_w17152246 crossref_primary_10_1016_j_jhazmat_2019_121688 crossref_primary_10_1016_j_scitotenv_2022_155994 crossref_primary_10_2337_dc18_2254 crossref_primary_10_1016_j_jes_2024_03_034 crossref_primary_10_3389_fendo_2021_745716 crossref_primary_10_1007_s11356_022_24182_3 crossref_primary_10_1097_EE9_0000000000000365 crossref_primary_10_1016_j_cclet_2025_110957 crossref_primary_10_1093_toxsci_kfae049 crossref_primary_10_1016_j_scitotenv_2022_156299 crossref_primary_10_1016_j_envint_2023_108093 crossref_primary_10_3389_fphys_2023_1103141 crossref_primary_10_3390_metabo14070392 crossref_primary_10_1016_j_scitotenv_2025_178803 crossref_primary_10_1289_EHP8054 crossref_primary_10_1016_j_tox_2022_153283 crossref_primary_10_1002_bit_27981 crossref_primary_10_1016_j_ijheh_2020_113607 crossref_primary_10_1016_j_chemosphere_2021_130359 crossref_primary_10_1016_j_envpol_2020_114458 crossref_primary_10_2215_CJN_06780619 crossref_primary_10_1016_j_envpol_2021_117707 crossref_primary_10_1016_j_tox_2022_153281 crossref_primary_10_1016_j_ecoenv_2024_116368 crossref_primary_10_3389_fchem_2021_771473 crossref_primary_10_1007_s11356_023_28395_y crossref_primary_10_1016_j_jes_2024_03_022 crossref_primary_10_1016_j_envint_2022_107159 crossref_primary_10_3390_ijerph17218020 crossref_primary_10_1007_s11356_023_26384_9 crossref_primary_10_3390_ijerph17041319 crossref_primary_10_1007_s12403_023_00551_2 crossref_primary_10_1093_eep_dvac010 crossref_primary_10_3390_toxics10060334 crossref_primary_10_3390_toxics12050314 crossref_primary_10_1016_j_envint_2021_106919 crossref_primary_10_1080_09603123_2024_2338269 crossref_primary_10_1016_j_eururo_2022_08_019 crossref_primary_10_1016_j_eururo_2025_06_005 crossref_primary_10_1016_j_cis_2024_103343 crossref_primary_10_1016_j_scitotenv_2024_173902 crossref_primary_10_1016_j_ecoenv_2021_113060 crossref_primary_10_1016_j_cbi_2024_111290 crossref_primary_10_1007_s11356_023_30317_x crossref_primary_10_1016_j_chemosphere_2024_143745 crossref_primary_10_1016_j_envint_2023_108197 crossref_primary_10_1016_j_envint_2020_106375 crossref_primary_10_1007_s00216_024_05426_2 crossref_primary_10_3390_toxics11010032 crossref_primary_10_1002_etc_5138 crossref_primary_10_1016_j_envint_2024_108556 crossref_primary_10_1016_j_tox_2020_152565 crossref_primary_10_1038_s41370_024_00742_2 crossref_primary_10_1016_j_cej_2022_139964 crossref_primary_10_1016_j_envres_2021_111860 crossref_primary_10_1371_journal_pone_0331286 crossref_primary_10_3389_ftox_2022_881584 crossref_primary_10_3390_ijms22030995 crossref_primary_10_1186_s12302_023_00721_8 crossref_primary_10_3390_nu13113902 crossref_primary_10_1016_j_envres_2022_115057 crossref_primary_10_1016_j_scitotenv_2024_177019 crossref_primary_10_1038_s41581_020_00363_6 crossref_primary_10_1016_j_envres_2022_113431 crossref_primary_10_1021_acs_chemrestox_4c00528 crossref_primary_10_1016_j_jece_2021_105271 crossref_primary_10_1016_j_envint_2020_105789 crossref_primary_10_1016_j_jhazmat_2024_133500 crossref_primary_10_3390_ijerph192214761 crossref_primary_10_1038_s41370_023_00564_8 crossref_primary_10_1016_j_jece_2024_112859 crossref_primary_10_3390_bioengineering12040393 crossref_primary_10_1016_j_ecoenv_2020_111497 crossref_primary_10_1016_j_jhazmat_2024_134312 crossref_primary_10_1007_s11356_022_23881_1 crossref_primary_10_1002_cbic_202300159 crossref_primary_10_1097_JOM_0000000000002527 crossref_primary_10_1016_j_jenvman_2022_117076 crossref_primary_10_1016_j_radphyschem_2020_109323 crossref_primary_10_1177_07482337241300722 crossref_primary_10_1007_s12209_023_00356_z crossref_primary_10_3390_ijerph182312550 crossref_primary_10_1016_j_envint_2020_106151 crossref_primary_10_1016_j_scitotenv_2021_148343 crossref_primary_10_1016_j_envres_2024_120598 crossref_primary_10_1016_j_envres_2019_04_034 crossref_primary_10_1002_adsc_202101499 crossref_primary_10_1016_j_envpol_2023_122429 crossref_primary_10_1016_j_envint_2020_106308 crossref_primary_10_3389_fpubh_2023_1136454 crossref_primary_10_1016_j_envpol_2023_121579 crossref_primary_10_3389_fvets_2024_1500651 crossref_primary_10_1016_j_chemosphere_2022_136438 crossref_primary_10_1016_j_envpol_2022_119020 crossref_primary_10_1016_j_scitotenv_2022_156499 crossref_primary_10_3390_cancers14122919 crossref_primary_10_3390_ijms26146658 crossref_primary_10_1016_j_envint_2019_105160 crossref_primary_10_1016_j_jes_2019_04_012 crossref_primary_10_1007_s11356_021_14454_9 crossref_primary_10_3390_ijerph17051668 crossref_primary_10_1016_j_chemosphere_2024_141237 crossref_primary_10_1007_s10311_021_01340_6 crossref_primary_10_1016_j_envint_2021_106964 crossref_primary_10_1007_s10661_024_13334_2 crossref_primary_10_1016_j_scitotenv_2020_139186 crossref_primary_10_1016_j_chemosphere_2023_139411 crossref_primary_10_3389_fmed_2025_1569031 crossref_primary_10_3390_su17156957 crossref_primary_10_1016_j_envpol_2021_116929 crossref_primary_10_35371_aoem_2023_35_e5 crossref_primary_10_1016_j_colsurfa_2018_10_024 crossref_primary_10_1016_j_chemosphere_2020_127255 crossref_primary_10_1093_jnci_djaa143 crossref_primary_10_1016_j_scitotenv_2023_168738 crossref_primary_10_1016_j_jhazmat_2023_132660 crossref_primary_10_34067_KID_0007962021 crossref_primary_10_1016_j_ijheh_2023_114215 crossref_primary_10_1038_s41598_023_41953_1 crossref_primary_10_1002_jeq2_20607 crossref_primary_10_1016_j_scitotenv_2023_165184 crossref_primary_10_1016_j_envres_2025_121181 crossref_primary_10_3389_fpubh_2025_1526070 crossref_primary_10_1016_j_chroma_2023_464522 crossref_primary_10_1016_j_scitotenv_2022_153900 crossref_primary_10_1007_s10532_020_09917_8 crossref_primary_10_1007_s13273_024_00474_2 crossref_primary_10_1016_j_chemosphere_2023_139563 crossref_primary_10_1016_j_bcp_2021_114902 crossref_primary_10_1016_j_scitotenv_2024_172840 crossref_primary_10_1146_annurev_pharmtox_021921_093352 crossref_primary_10_1016_j_envres_2018_11_033 crossref_primary_10_3390_pr11061856 crossref_primary_10_1016_j_envint_2019_105034 crossref_primary_10_1021_jacs_0c04937 crossref_primary_10_1038_s41370_021_00288_7 crossref_primary_10_1080_15376516_2025_2537893 crossref_primary_10_1016_j_chemosphere_2019_124615 crossref_primary_10_1371_journal_pone_0245141 crossref_primary_10_3390_ani14040529 crossref_primary_10_1097_MCC_0000000000000658 crossref_primary_10_1891_0739_6686_38_159 crossref_primary_10_1038_s41370_025_00785_z crossref_primary_10_1016_j_ijbiomac_2025_141425 crossref_primary_10_1002_etc_4890 crossref_primary_10_3390_pollutants4010009 crossref_primary_10_1053_j_ajkd_2021_01_010 crossref_primary_10_1016_j_chemosphere_2018_11_191 crossref_primary_10_1007_s00204_024_03685_7 crossref_primary_10_1177_17562872211029799 crossref_primary_10_1016_j_ecoenv_2024_117395 |
| ContentType | Journal Article |
| Copyright | Copyright © 2018 by the American Society of Nephrology. |
| Copyright_xml | – notice: Copyright © 2018 by the American Society of Nephrology. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.2215/CJN.04670418 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1555-905X |
| ExternalDocumentID | 30213782 |
| Genre | Journal Article Scoping Review |
| GroupedDBID | --- 0R~ 29B 2WC 53G 5GY 5VS 6PF AAOCO AAQQT AAUIN AAWTL ABBLC ABJNI ABXYN ACLDA ACZKN ADBBV AENEX AFEXH AFNMH AHOMT AHQVU ALMA_UNASSIGNED_HOLDINGS BAWUL BTFSW CGR CS3 CUY CVF DIK DU5 EBS ECM EIF EJD ERAAH F5P GX1 H13 HYE HZ~ KQ8 NPM O9- OK1 OVD P2P RHI RPM TEORI TNP TR2 W8F WOQ 7X8 ADSXY |
| ID | FETCH-LOGICAL-c346t-d64b2b23b3119ed6dba2830dcf10ce72671ca15d09304487c304382d9067fd242 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 177 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000446977600008&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1555-905X |
| IngestDate | Fri Sep 05 11:27:29 EDT 2025 Mon Jul 21 05:26:39 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 10 |
| Keywords | Actin Cytoskeleton Health Disparities Kidney Diseases Epidemiologic Studies Peroxisome Proliferators Global Health Exposure Permeability kidney Toxicology Kidney Tubules, Proximal Epithelial-Mesenchymal Transition Environment NF-E2-Related Factor 2 Pollutants oxidative stress |
| Language | English |
| License | Copyright © 2018 by the American Society of Nephrology. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c346t-d64b2b23b3119ed6dba2830dcf10ce72671ca15d09304487c304382d9067fd242 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
| ORCID | 0000-0001-6379-300 |
| PMID | 30213782 |
| PQID | 2105061221 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2105061221 pubmed_primary_30213782 |
| PublicationCentury | 2000 |
| PublicationDate | 2018-10-08 |
| PublicationDateYYYYMMDD | 2018-10-08 |
| PublicationDate_xml | – month: 10 year: 2018 text: 2018-10-08 day: 08 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Clinical journal of the American Society of Nephrology |
| PublicationTitleAlternate | Clin J Am Soc Nephrol |
| PublicationYear | 2018 |
| SSID | ssj0044325 |
| Score | 2.6207392 |
| SecondaryResourceType | review_article |
| Snippet | Per- and polyfluoroalkyl substances (PFASs) are a large group of manufactured nonbiodegradable compounds. Despite increasing awareness as global pollutants,... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 1479 |
| SubjectTerms | Environmental Exposure - adverse effects Environmental Pollutants - adverse effects Fluorocarbon Polymers - adverse effects Humans Kidney Diseases - chemically induced |
| Title | Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health: A Scoping Review |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/30213782 https://www.proquest.com/docview/2105061221 |
| Volume | 13 |
| WOSCitedRecordID | wos000446977600008&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3dS8MwEA_qRHzx-2N-EcHXuDZJm8YXGWNDlJWBE_oiJW0THEg7103wv_fSdu5JEHzpW0O5XHO_3O_ufgjdiEAlWnOXaO0nhLtOQJQ0PvzxqXIpAASfJZXYhAjDIIrkqEm4lU1Z5fJMrA7qrEhtjrwDVxPPhmPq3k8_iFWNsuxqI6GxjloMoIwt6RLRD4vAOatEVyFkekQ6XlQXvsMSXqf3GN7C1VA43A1-B5dVkBns_vfz9tBOAy9xt_aHfbSm8wO0NWwI9EP0OtIz876wVXcAMjO8nBdQYlVim6CymkW4v-p-g8XGbxZYlnhe4KdJlusvXPcu3eEufk6rhitcUwxH6GXQH_ceSKOwQFLG_TnJfJ7QhLKEua7UVltK2YFgWWpgr7SgvnBhy7zMkQysGYiUVcRhJiHGmQyi-zHayItcnyIsFSBNk1JqEsllogPFueSUOlIJ4zPTRtdLw8XgwZaWULkuFmW8Ml0bndTWj6f1qI2YAQRhAGLO_vD2OdoGNNMMq71ALQPG05doM_2cT8rZVeUa8AxHw280JcIq |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Perfluorinated+Chemicals+as+Emerging+Environmental+Threats+to+Kidney+Health%3A+A+Scoping+Review&rft.jtitle=Clinical+journal+of+the+American+Society+of+Nephrology&rft.au=Stanifer%2C+John+W&rft.au=Stapleton%2C+Heather+M&rft.au=Souma%2C+Tomokazu&rft.au=Wittmer%2C+Ashley&rft.date=2018-10-08&rft.issn=1555-905X&rft.eissn=1555-905X&rft.volume=13&rft.issue=10&rft.spage=1479&rft_id=info:doi/10.2215%2FCJN.04670418&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1555-905X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1555-905X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1555-905X&client=summon |