Editorial
Bisphenol A: An environmental factor implicated in renal vascular damage
El bisfenol A: un factor ambiental implicado en el daño nefrovascular
Ricardo José Boscha,
, Borja Quirogab, Carmen Muñoz-Morenoa, Nuria Olea-Herreroa, María Isabel Arenasc, Marta González-Santanderd, Paula Reventúne, Carlos Zaragozaf, Gabriel de Arribab,d, Marta Saurae
Corresponding author
a Laboratorio de Fisiología Renal y Nefrología Experimental, Unidad de Fisiología, Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, Spain
b Servicio de Nefrología, Hospital Universitario de Guadalajara, Guadalajara, Spain
c Unidad de Biología Celular, Departamento de Biomedicina y Biotecnología, Universidad de Alcalá, Alcalá de Henares, Spain
d Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Alcalá de Henares, Spain
e Laboratorio de Fisiopatología de la Pared Vascular, Unidad de Fisiología, Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, Spain
f Laboratorio de Fisiopatología Cardiovascular, Unidad de Investigación Translacional, Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain
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"Marta" "apellidos" => "Saura" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Laboratorio de Fisiología Renal y Nefrología Experimental, Unidad de Fisiología, Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario de Guadalajara, Guadalajara, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Biología Celular, Departamento de Biomedicina y Biotecnología, Universidad de Alcalá, Alcalá de Henares, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Alcalá de Henares, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Laboratorio de Fisiopatología de la Pared Vascular, Unidad de Fisiología, Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Laboratorio de Fisiopatología Cardiovascular, Unidad de Investigación Translacional, Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El bisfenol A: un factor ambiental implicado en el daño nefrovascular" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "<span class="elsevierStyleItalic">Source</span>: Saura et al.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> reproduced with permission." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1190 "Ancho" => 1483 "Tamanyo" => 76991 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BPA induces hypertension in mice. The mice were treated with BPA at the doses indicated or with nothing (controls). Blood pressure was assessed 30 days after the administration of BPA. *<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05 compared with corresponding control (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years, exposure to certain chemical substances has become a part of everyday life. Such is the case with bisphenol A (BPA), or 2,2,-bis(4-hydroxyphenyl) propane, a molecule used to synthesize polycarbonate plastics and epoxy resins. It is used extensively in the production of babies’ bottles, water and soft drinks bottles, and as the inner coating of cans and other food and drink containers. It is not surprising, then, that in 2009 around 6<span class="elsevierStyleHsp" style=""></span>000<span class="elsevierStyleHsp" style=""></span>000 metric tonnes of BPA were generated worldwide.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Numerous studies have demonstrated that more than 90% of the population in the USA have detectable urinary levels of this compound and that the level of exposure of the population is above the recommended values: 50<span class="elsevierStyleHsp" style=""></span>μg per kg per day.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> In a recent study conducted in Spain, Cutanda et al.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> reported that BPA was present in the urine of 97% of the population studied.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Exposure to BPA occurs mainly via the oral route, but also from dental sealants, through the skin, and by inhalation of cleaning products. Even more concerning is the fact that studies conducted in Spain,<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> China, and Japan.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> have shown contamination of subterranean water and rivers with BPA.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Numerous studies<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1,5–8</span></a> consider that BPA interfere with to be an endocrine regulation. It has been studied the potential relationship between the oestrogenic activity (xenoestrogen) of BPA and different endocrine and metabolic abnormalities including hepatic and thyroid disorders, obesity, insulin resistance, and increased susceptibility to diabetes.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">From a renovascular perspective, the first concerns emerged in 2008 when Lang et al.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> found a significant correlation between a high urinary concentration of BPA and cardiovascular diseases in patients with type 2 diabetes.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">8,10</span></a> The present review will analyse first the critical role of renal function on BPA excretion, and secondly will analyse the experimental evidence that provides a solid scientific basis for translational clinical studies that implicate BPA in renovascular damage.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Accumulation of bisphenol A in patients with chronic kidney disease</span><p id="par0030" class="elsevierStylePara elsevierViewall">It has been established that after ingestion, BPA is conjugated in the liver with glucuronic acid, where it loses its oestrogenic activity and is then excreted to the intestine. Both BPA and its metabolites are excreted in urine.<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1–3,6</span></a> Therefore, patients with chronic kidney disease (CKD) have higher serum levels of BPA than the general population<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a>. A negative correlation has been observed between estimated glomerular filtration rate and the serum concentration of BPA.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> A recent study by Krieter et al., analysed a cohort of 152 patients with CKD and 24 controls; a significant increase in plasma concentrations of BPA was observed in CKD 3–5. The highest concentration of BPA was obtained in patients with CKD 5 (dialysis) with values of up to 6 times higher than controls without kidney disease.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11,12</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Currently, the BPA clearance by dialysis has not been established. This is a complex issue since the dialysis membranes themselves contain variable amounts of BPA. This has been proven by studies that demonstrate the presence of BPA in the effluents of polymethylmetacrylate, cellulose, cellulose triacetate, polyester polymer, and polysulphone membranes, particularly the latter.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11–13</span></a> It has also been demonstrated that BPA levels can rise or remain unchanged after dialysis sessions. This may be due to the fact that BPA is highly protein-bound, at approximately 75%.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Likewise, data were inconclusive on the role of residual diuresis in BPA excretion in CKD.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Therefore, further studies are needed to clarify the potential pathophysiological implications of BPA accumulation in CKD, and to evaluate whether BPA should be added to the long list of uraemic toxins.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Bisphenol A induces podocyte damage and proteinuria</span><p id="par0040" class="elsevierStylePara elsevierViewall">A recent study described a new type of podocytopathy induced by BPA.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> Olea-Herrero et al. observed that BPA could induce hypertrophy and apoptosis in cultured mouse podocytes. These effects were accompanied by an increase in the synthesis of molecules classically involved in the pathogenesis of glomerulosclerosis, such as the cyclin-dependent kinase inhibitor p27kip1, the TGF-β system, and collagen IV. Furthermore, in these cells, BPA reduced the synthesis of nephrin and podocin, proteins of the filtration slits involved in the mechanisms of both proteinuria and podocyte survival. As would be expected from these in vitro results, the kidneys of animals treated with BPA developed hypertrophy, hyperfiltration, and proteinuria. Along with the increased renal expression of p27kip1, TGF-β, and collagen IV, mesangial expansion and a decrease in the number of podocytes due to apoptosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) were also seen. Electron microscopy showed hypertrophy of podocytes and pedicles. It should be noted that even when animals treated with BPA did not develop hyperglycaemia, their kidneys showed structural and functional changes similar to those that occur in the initial stages of diabetic nephropathy (DN). Although there are limitations to the use of animal models in the development of renal failure or long-term histomorphological renal changes,<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> these findings may have pathophysiological implications, given that proteinuria is a good predictor of progression of kidney disease.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Bisphenol A induces endothelial dysfunction and hypertension</span><p id="par0045" class="elsevierStylePara elsevierViewall">Subsequent studies<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> demonstrated that animals treated with BPA developed arterial hypertension and endothelial dysfunction, in a dose-dependent manner. This effect could be observed at doses lower that half of those considered safe (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Microarray analysis of genetic expression in murine endothelial cells treated with BPA demonstrated the activation of genes involved in vascular regulation such as angiotensin II and calcium-calmodulin kinase II (CaMKII). This was subsequently observed in vivo as well. This activation is responsible for the endothelial dysfunction and hypertension induced by BPA, given that CaMKII activation promotes the enzymatic uncoupling of endothelial nitric oxide synthase. This leads to the production of oxygen free radicals instead of nitric oxide, a primary vasodilator and endothelial protector. This increased production of oxygen free radicals indicates that BPA, as well as inducing hypertension, could participate in vascular damage mechanisms and in the progression of atherosclerotic lesions.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Human exposure to bisphenol A and renovascular damage</span><p id="par0050" class="elsevierStylePara elsevierViewall">Recent studies have emphasised the interest of experimental rodent models for the study of BPA toxicity. It is important to recognise that BPA has equal potency in human and animal cells.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> Experimental data implicating BPA in renovascular damage have gained particular relevance. Results obtained experimentally are supported by epidemiological studies conducted in the populations of New York,<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> Shanghai,<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> and Seoul,<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> which describe an association between human exposure to BPA and an increased in proteinuria and hypertension.</p><p id="par0055" class="elsevierStylePara elsevierViewall">From a nephrological perspective, two large population studies should be mentioned. One of them was a large adult Chinese population (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3077)<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> and the other involved 710 children in the United States.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> Both studies demonstrated a significant association between urinary excretion of BPA concentration and albuminuria. This association persisted independently of sex, diabetes, smoking status, hypertension, or CKD. The authors of both studies speculated about the possible role of oxidative stress and endothelial dysfunction to explain the findings. However, current experimental data show that even a low-grade albuminuria associated with BPA exposure could promote podocytopathy of uncertain (or at least unexplored) prognosis. This indicates the need to conduct further studies and to re-evaluate the necessity of preventing or limiting BPA exposure.</p><p id="par0060" class="elsevierStylePara elsevierViewall">From a cardiovascular perspective, numerous clinical and epidemiological studies have demonstrated that exposure to BPA is associated with hypertension and vascular damage.<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">22–25</span></a> In a sample representative of the adult USA population, Shankar and Teppala<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> found that high urinary BPA excretion was associated with arterial hypertension independently of other classic risk factors. Similar results were found in the adult population of Seoul, where 1511 analyses were performed on 521 individuals.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> Likewise, Bae and Hong<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> studied the acute effect of oral exposure to BPA in 60 people following the ingestion of 2 servings of the same substance (soya milk) packaged in either a can or a bottle: with canned drinks, high urinary BPA was associated with increased blood pressure 2<span class="elsevierStyleHsp" style=""></span>h after consumption.</p><p id="par0065" class="elsevierStylePara elsevierViewall">There are various studies associating BPA exposure to vascular damage. In Norfolk (United Kingdom), Melzer et al.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> evaluated 758 cases of coronary artery disease and 861 control subjects over a follow-up period of 10.8 years. They demonstrated a significant association between high urinary BPA concentration and incident coronary artery disease. Similar results have been published in studies from the National Health and Nutritional Survey (NHANES) of the USA<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> in which the authors, after analysing 745 subjects, found a significant association between urinary BPA level and peripheral arterial disease, independently of classic risk factors.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The implications of these findings are obvious due to both the high incidence in the population and the morbidity and mortality of renovascular disease. It is well established that cardiovascular disease is the most common cause of death in developed countries, with approximately one quarter of the population having some form of this disease.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17,21–25</span></a> The same may occur in CKD, in which BPA accumulates and could be deemed a uraemic toxin.</p><p id="par0075" class="elsevierStylePara elsevierViewall">It is difficult to definitively characterise the potentially harmful concentration of BPA. However, it is worth mentioning the findings of 2 independent studies in which the consumption of a daily dose of canned beverage produced, after 3<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> to 5<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> days, an increase in urinary BPA concentration of over 1000% (over 20<span class="elsevierStyleHsp" style=""></span>ng/mL). Li et al.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> described an association between BPA exposure and albuminuria in adults, with some individuals having a mean urinary BPF concentration of 1<span class="elsevierStyleHsp" style=""></span>ng/mL. Thus, the BPA exposure demonstrated in repeated epidemiological studies, conducted mainly in developed countries,<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> is within the range associated with proteinuria and hypertension.</p><p id="par0080" class="elsevierStylePara elsevierViewall">In addition, since the end of the last century, a worldwide epidemic of type 2 diabetes – the most common cause of CKD in developed countries – has been detected. Data from the Registry of the Spanish Society of Nephrology estimate that in 21% of patients, CKD is caused by Diabetic Nephropathy (DN).<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> Although classically DN has been considered a metabolic disease, studies by Navarro et al.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> demonstrated the presence of an inflammatory component of DN. Given that only 20–40% of patients with diabetes develop nephropathy, it is suggested that there are other (genetic) diabetes-inducing factors involved that are yet to be discovered.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> Current investigations allow us to hypothesise that the environmental factor BPA may induce or potentiate changes in the kidney that occur in diabetes mellitus. It is worth mentioning, finally, that in USA the FDA has proposed to sponsor research on BPA.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="par0085" class="elsevierStylePara elsevierViewall">The available scientific data allow the identification of BPA as a new environmental factor implicated in renovascular damage. This is characterised by podocytopathy with proteinuria, arterial hypertension, and vascular dysfunction. These data also support the need for translational studies in an attempt to clarify the potential role of BPA in hypertension and in the progression of kidney disease, particularly in patients with diabetes.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Accumulation of bisphenol A in patients with chronic kidney disease" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Bisphenol A induces podocyte damage and proteinuria" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Bisphenol A induces endothelial dysfunction and hypertension" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Human exposure to bisphenol A and renovascular damage" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 6 => array:2 [ "identificador" => "xack275766" "titulo" => "Acknowledgements" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Bosch RJ, Quiroga B, Muñoz-Moreno C, Olea-Herrero N, Arenas MI, González-Santander M, et al. El bisfenol A: un factor ambiental implicado en el daño nefrovascular. Respuesta. Nefrología. 2016;36:5–9.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "<span class="elsevierStyleItalic">Source</span>: Olea-Herrero et al.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> reproduced with permission." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2782 "Ancho" => 2607 "Tamanyo" => 456076 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">BPA produces podocytopoenia in mice. (A) Immunohistochemistry for WT-1. In mice treated with BPA the number of podocytes (brown nuclei) was lower than in controls. 300×. (B) TUNEL assay (black nuclei) combined with immunohistochemistry for podocin (grey expansions). The renal corpuscles of those mice treated with BPA showed a higher number of apoptotic podocytes than controls. 300×. (C) Left, graph representing the statistical analysis of the number of podocytes. Right, histogram representing the number of apoptotic cells in mice treated with BPA and in controls. ***<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001 using ANOVA for analysis of variance.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "<span class="elsevierStyleItalic">Source</span>: Saura et al.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> reproduced with permission." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1190 "Ancho" => 1483 "Tamanyo" => 76991 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BPA induces hypertension in mice. The mice were treated with BPA at the doses indicated or with nothing (controls). Blood pressure was assessed 30 days after the administration of BPA. *<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05 compared with corresponding control (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0155" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bisphenol A and human chronic diseases: current evidences, possible mechanisms, and future perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Rezg" 1 => "S. El-Fazaa" 2 => "N. Gharbi" 3 => "B. 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MS received funding from the <span class="elsevierStyleGrantSponsor" id="gs3">Spanish Ministry for Economy and Competitiveness</span> (<span class="elsevierStyleGrantNumber" refid="gs3">SAF 2012-35141</span>) and a grant from the <span class="elsevierStyleGrantSponsor" id="gs4">Spanish Society of Nephrology Foundation</span> (<span class="elsevierStyleItalic">Ayudas Fundación Senefro</span>) 2012. CZ received funding from the <span class="elsevierStyleGrantSponsor" id="gs5">Spanish Ministry for Economy and Competitiveness</span> (<span class="elsevierStyleGrantNumber" refid="gs5">SAF 2008-04629</span> and <span class="elsevierStyleGrantNumber" refid="gs5">SAF 2011-28375</span>), and the <span class="elsevierStyleGrantSponsor" id="gs6"><span class="elsevierStyleItalic">Instituto de Salud Carlos III-FEDER</span></span> (<span class="elsevierStyleGrantNumber" refid="gs6">PI14/02022</span>). N. Olea has a research contract with the Autonomous Community of Madrid-Programme of Activities in R+D in Biosciences 2010 (S2010/BMD-2378). P. Reventún has a research contract with the Ministry of Economy and Competitiveness.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003600000001/v2_201703300133/S2013251416000109/v2_201703300133/en/main.assets" "Apartado" => array:4 [ "identificador" => "35429" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003600000001/v2_201703300133/S2013251416000109/v2_201703300133/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251416000109?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 6 | 12 |
| 2024 October | 40 | 54 | 94 |
| 2024 September | 50 | 27 | 77 |
| 2024 August | 61 | 67 | 128 |
| 2024 July | 49 | 37 | 86 |
| 2024 June | 64 | 33 | 97 |
| 2024 May | 61 | 29 | 90 |
| 2024 April | 58 | 43 | 101 |
| 2024 March | 45 | 20 | 65 |
| 2024 February | 45 | 35 | 80 |
| 2024 January | 40 | 26 | 66 |
| 2023 December | 33 | 20 | 53 |
| 2023 November | 40 | 30 | 70 |
| 2023 October | 66 | 39 | 105 |
| 2023 September | 32 | 26 | 58 |
| 2023 August | 41 | 30 | 71 |
| 2023 July | 44 | 17 | 61 |
| 2023 June | 44 | 16 | 60 |
| 2023 May | 64 | 24 | 88 |
| 2023 April | 32 | 15 | 47 |
| 2023 March | 65 | 16 | 81 |
| 2023 February | 46 | 17 | 63 |
| 2023 January | 35 | 30 | 65 |
| 2022 December | 61 | 30 | 91 |
| 2022 November | 55 | 31 | 86 |
| 2022 October | 77 | 45 | 122 |
| 2022 September | 56 | 40 | 96 |
| 2022 August | 75 | 50 | 125 |
| 2022 July | 51 | 50 | 101 |
| 2022 June | 34 | 47 | 81 |
| 2022 May | 67 | 36 | 103 |
| 2022 April | 47 | 53 | 100 |
| 2022 March | 53 | 55 | 108 |
| 2022 February | 52 | 42 | 94 |
| 2022 January | 56 | 41 | 97 |
| 2021 December | 53 | 38 | 91 |
| 2021 November | 54 | 43 | 97 |
| 2021 October | 42 | 47 | 89 |
| 2021 September | 60 | 34 | 94 |
| 2021 August | 40 | 31 | 71 |
| 2021 July | 78 | 34 | 112 |
| 2021 June | 55 | 33 | 88 |
| 2021 May | 63 | 59 | 122 |
| 2021 April | 94 | 33 | 127 |
| 2021 March | 76 | 36 | 112 |
| 2021 February | 67 | 38 | 105 |
| 2021 January | 44 | 20 | 64 |
| 2020 December | 62 | 27 | 89 |
| 2020 November | 66 | 20 | 86 |
| 2020 October | 33 | 19 | 52 |
| 2020 September | 51 | 21 | 72 |
| 2020 August | 64 | 9 | 73 |
| 2020 July | 56 | 20 | 76 |
| 2020 June | 40 | 20 | 60 |
| 2020 May | 77 | 21 | 98 |
| 2020 April | 40 | 26 | 66 |
| 2020 March | 45 | 17 | 62 |
| 2020 February | 124 | 29 | 153 |
| 2020 January | 133 | 25 | 158 |
| 2019 December | 103 | 29 | 132 |
| 2019 November | 87 | 23 | 110 |
| 2019 October | 40 | 11 | 51 |
| 2019 September | 36 | 19 | 55 |
| 2019 August | 34 | 20 | 54 |
| 2019 July | 41 | 24 | 65 |
| 2019 June | 34 | 18 | 52 |
| 2019 May | 39 | 15 | 54 |
| 2019 April | 62 | 23 | 85 |
| 2019 March | 57 | 31 | 88 |
| 2019 February | 34 | 24 | 58 |
| 2019 January | 32 | 27 | 59 |
| 2018 December | 224 | 42 | 266 |
| 2018 November | 485 | 19 | 504 |
| 2018 October | 311 | 25 | 336 |
| 2018 September | 132 | 26 | 158 |
| 2018 August | 66 | 23 | 89 |
| 2018 July | 56 | 12 | 68 |
| 2018 June | 78 | 19 | 97 |
| 2018 May | 109 | 13 | 122 |
| 2018 April | 90 | 14 | 104 |
| 2018 March | 146 | 11 | 157 |
| 2018 February | 67 | 11 | 78 |
| 2018 January | 55 | 8 | 63 |
| 2017 December | 64 | 7 | 71 |
| 2017 November | 62 | 15 | 77 |
| 2017 October | 61 | 16 | 77 |
| 2017 September | 49 | 8 | 57 |
| 2017 August | 48 | 14 | 62 |
| 2017 July | 45 | 17 | 62 |
| 2017 June | 59 | 15 | 74 |
| 2017 May | 52 | 14 | 66 |
| 2017 April | 41 | 8 | 49 |
| 2017 March | 38 | 13 | 51 |
| 2017 February | 56 | 11 | 67 |
| 2017 January | 16 | 7 | 23 |
| 2016 December | 38 | 7 | 45 |
| 2016 November | 75 | 15 | 90 |
| 2016 October | 113 | 7 | 120 |
| 2016 September | 184 | 7 | 191 |
| 2016 August | 104 | 0 | 104 |
| 2016 July | 146 | 5 | 151 |
| 2016 June | 130 | 0 | 130 |
| 2016 May | 154 | 0 | 154 |
| 2016 April | 119 | 0 | 119 |
| 2016 March | 90 | 0 | 90 |
| 2016 February | 53 | 0 | 53 |
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