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

Daou, Rouaa; Hoteit, Maha; Chémali, Jad; Tzenios, Nikolaos; Fares, Nassim; Khoury, André El

doi:10.3390/toxins17120577

This is an early access version, the complete PDF, HTML, and XML versions will be available soon.

Open AccessArticle

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

by

Rouaa Daou

^1,†

,

Maha Hoteit

^2,3,4,†

,

Jad Chémali

⁵

,

Nikolaos Tzenios

^6,*

,

Nassim Fares

⁷

and

André El Khoury

^1,*

¹

Centre d’Analyses et de Recherche (CAR), Unité de Recherche Technologies et Valorisation Agro-Alimentaire (UR-TVA), Faculty of Sciences, Campus of Sciences and Technologies, Saint Joseph University of Beirut, Beirut PO Box 17-5208, Lebanon

²

PHENOL Research Program, Faculty of Public Health, Section 1, Lebanese University, Beirut P.O. Box 6573, Lebanon

³

Department of Primary Care and Population Health, University of Nicosia Medical School, P.O. Box 24005 Nicosia, Cyprus

⁴

INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon

⁵

Laboratoire de Cancérologie et d’agents cancérogènes, Faculty of Medicine, Saint Joseph University of Beirut, Beirut PO Box 17-5208, Lebanon

⁶

Faculty of Public Health, Charisma University, London EC1V 7QE, UK

⁷

Laboratory of Research in Physiology and Pathophysiology, Faculty of Medicine, Saint Joseph University of Beirut Beirut PO Box 17-5208, Lebanon

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Toxins 2025, 17(12), 577; https://doi.org/10.3390/toxins17120577 (registering DOI)

Submission received: 22 October 2025 / Revised: 26 November 2025 / Accepted: 26 November 2025 / Published: 30 November 2025

(This article belongs to the Special Issue Mycotoxins—Biomonitoring and Exposure)

Download

Browse Figure

Versions Notes

Abstract

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.

Keywords: mycotoxins; dietary exposure; ochratoxin A (OTA); Lebanese adolescents; public health risk; kidney injury biomarkers

Graphical Abstract

Share and Cite

MDPI and ACS Style

Daou, R.; Hoteit, M.; Chémali, J.; Tzenios, N.; Fares, N.; Khoury, A.E. Assessing Kidney Injury Biomarkers and OTA Exposure in Urine of Lebanese Adolescents Amid Economic Crisis and Evolving Dietary Patterns. Toxins 2025, 17, 577. https://doi.org/10.3390/toxins17120577

AMA Style

Daou R, Hoteit M, Chémali J, Tzenios N, Fares N, Khoury AE. Assessing Kidney Injury Biomarkers and OTA Exposure in Urine of Lebanese Adolescents Amid Economic Crisis and Evolving Dietary Patterns. Toxins. 2025; 17(12):577. https://doi.org/10.3390/toxins17120577

Chicago/Turabian Style

Daou, Rouaa, Maha Hoteit, Jad Chémali, Nikolaos Tzenios, Nassim Fares, and André El Khoury. 2025. "Assessing Kidney Injury Biomarkers and OTA Exposure in Urine of Lebanese Adolescents Amid Economic Crisis and Evolving Dietary Patterns" Toxins 17, no. 12: 577. https://doi.org/10.3390/toxins17120577

APA Style

Daou, R., Hoteit, M., Chémali, J., Tzenios, N., Fares, N., & Khoury, A. E. (2025). Assessing Kidney Injury Biomarkers and OTA Exposure in Urine of Lebanese Adolescents Amid Economic Crisis and Evolving Dietary Patterns. Toxins, 17(12), 577. https://doi.org/10.3390/toxins17120577

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Menu

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

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Further Information

Guidelines

MDPI Initiatives

Follow MDPI