Microplastic exposure and kidney disease: an emerging environmental nephrotoxin in the Anthropocene

Authors

Zayan, Tariq A.; Khafagy, H. A.

Citation

Arab J Nephrol Transplant. 2026;8(1):1–10.

Abstract

Background: Microplastics (MPs) and nanoplastics (NPs) are ubiquitous environmental pollutants resulting in universal human exposure. While cardiovascular effects are emerging, a systematic evaluation of their role as a nephrotoxic agent is needed, particularly concerning chronic kidney disease progression. Objectives: This review critically evaluates the current knowledge on MP/NP exposure and kidney disease, focusing on exposure pathways, renal bioaccumulation, cellular and molecular mechanisms of toxicity, and the emerging clinical and epidemiological evidence. Methods: A comprehensive literature search of PubMed, Scopus, and Web of Science was conducted, with an emphasis on evidence from 2020 to 2025. Human studies, animal models, and in vitro experiments were included to synthesize the current understanding of MP-induced nephrotoxicity. Results: MPs are detected in human kidneys, urine, and blood, with exposure occurring via ingestion (39 000–52 000 particles/year) and inhalation (up to 68 000 particles/day). Mechanistically, MPs induce renal injury through oxidative stress, endoplasmic reticulum stress, inflammation, autophagy dysregulation, and fibrosis. Animal models confirm histological and functional kidney alterations. Dialysis patients represent a high-risk population, with significant weekly exposure from dialysis fluids (9.57–14.28 mp/l). The presence of MPs in atheromas is associated with increased major adverse cardiovascular events, highlighting the cardiorenal risk. Conclusions: MPs represent a novel and significant nephrotoxic threat. Urgent research is needed to establish the epidemiological link between MP exposure and chronic kidney disease. The development of clinical monitoring strategies and the implementation of public health interventions are essential to mitigate the health impacts of this escalating environmental concern.

Full text (excerpt)

Background Microplastics (MPs, 5 mm) and nanoplastics (NPs, 1 m) are ubiquitous environmental pollutants resulting in universal human exposure. While cardiovascular effects are emerging, a systematic evaluation of their role as a nephrotoxic agent is needed, particularly concerning chronic kidney disease (CKD) progression. Objectives This review critically evaluates the current knowledge on MP/NP exposure and kidney disease, focusing on exposure pathways, renal bioaccumulation, cellular and molecular mechanisms of toxicity, and the emerging clinical and epidemiological evidence. Methods A comprehensive literature search of PubMed , Scopus , and Web of Science was conducted between 2020 and 2025. Human studies, animal models, and in vitro experiments were included to synthesize the current understanding of MP-induced nephrotoxicity. Search Strategy Search terms combined microplastic OR nanoplastic with kidney OR renal OR nephrotoxicity OR CKD . Two reviewers independently screened titles and abstracts. Results Microplastics are detected in human kidneys, urine, and blood, with exposure occurring via ingestion (39 000 52 000 particles/year) and inhalation (up to 68 000 particles/day)

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The Arab Journal of Nephrology and Transplantation is the peer-reviewed open-access journal of ASNRT, published since 2008.

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