Assessing Kidney Injury Biomarkers and OTA Exposure in Urine of Lebanese Adolescents Amid Economic Crisis and Evolving Dietary Patterns.

Although ochratoxin A (OTA) contamination has been previously reported in Lebanon, this study is the first worldwide to assess its potential impact on renal health among adolescents aged 10 to 18 years. In this cross-sectional study, the aim was to evaluate the levels of OTA, OTα, and kidney injury biomarkers, as well as creatinuria and total proteinuria, while correlating these findings with dietary patterns. Urinary concentrations of OTA, its main metabolite ochratoxin α (OTa), the three renal injury biomarkers (N-acetyl-β-D-glucosaminidase [NAG], Kidney Injury Molecule-1 [KIM-1], and human lipocalin-2 [NGAL]), and two renal function indicators (creatinine and total protein) were quantified. Associations between biomarker levels and dietary intake patterns were also evaluated. OTA and OTα were detected in 14.2% and 59.5% of urine samples, respectively. NGAL and NAG were found in all participants at low concentrations, with the NAG-to-creatinine ratio exceeding the clinical threshold in 1.5% of samples, while KIM-1 was detected in 86% of participants. A weak positive correlation between urinary OTα and NAG suggests subtle renal alterations possibly linked to OTA exposure. Correlations between biomarker levels and food consumption were generally weak and positive. Estimated dietary intake (EDI) of OTA generated from consumption patterns was shown to be less than the probable dietary intake (PDI) calculated from urinary OTA. However, this presented a limitation, as EDI was calculated from previous contamination data in Lebanon. Overall, these findings indicate that while renal injury biomarkers were present at low levels, they may reflect early kidney stress not yet manifesting as overt pathology and highlight the need for strengthened regulatory measures to limit OTA contamination in foods available on the Lebanese market and for longitudinal studies to confirm these preliminary findings.