Paralytic shellfish toxins in Australian Southern Rock Lobster (<i>Jasus edwardsii</i>): Acute human exposure from consumption of hepatopancreas

<p>Paralytic shellfish toxins (PST) were identified in the hepatopancreas of Southern Rock Lobster (<i>Jasus edwardsii</i>) during <i>Alexandrium tamarense</i> blooms in Tasmania, Australia. Human health risk from PST in lobsters was unknown – this study assesses exposure to PST from hepatopancreas consumption. Lobster hepatopancreas samples collected during blooms (n = 181) were mostly positive for PST (>88%), the highest concentration was 4032 μg STX-2HCl eq/kg. Consumer exposure to PST was estimated using a 2-D Monte Carlo model. Mean PST intake (<i>pi</i>) from hepatopancreas consumption (raw and cooked) was below the lowest-observed-adverse-effect-level (LOAEL) for PST (<2.0 μg/kg bw), however the 97.5th percentile <i>pi</i> for raw meals (2.64 μg/kg bw) exceeded the LOAEL. A total of 4.1% of raw hepatopancreas meals were estimated to exceed the LOAEL. Lobster hepatopancreas consumption during <i>A. tamarense</i> blooms may be concerning for a small proportion of consumers, particularly those that eat large meals at the bloom peak. However, when the model was re-run with PST concentration capped at the bivalve regulatory limit (800 μg STX-2HCl eq/kg) <i>pi</i> decreased, with the 97.5th percentile values below the LOAEL. Thus, issuing public health warnings and harvesting restrictions for lobsters when levels exceed 800 μg STX-2HCl eq/kg would reduce the probability of illness occurring.</p

Effects of rare kidney diseases on kidney failure: a longitudinal analysis of the UK National Registry of Rare Kidney Diseases (RaDaR) cohort

Individuals with rare kidney diseases account for 5-10% of people with chronic kidney disease, but constitute more than 25% of patients receiving kidney replacement therapy. The National Registry of Rare Kidney Diseases (RaDaR) gathers longitudinal data from patients with these conditions, which we used to study disease progression and outcomes of death and kidney failure.People aged 0-96 years living with 28 types of rare kidney diseases were recruited from 108 UK renal care facilities. The primary outcomes were cumulative incidence of mortality and kidney failure in individuals with rare kidney diseases, which were calculated and compared with that of unselected patients with chronic kidney disease. Cumulative incidence and Kaplan-Meier survival estimates were calculated for the following outcomes: median age at kidney failure; median age at death; time from start of dialysis to death; and time from diagnosis to estimated glomerular filtration rate (eGFR) thresholds, allowing calculation of time from last eGFR of 75 mL/min per 1·73 m2 or more to first eGFR of less than 30 mL/min per 1·73 m2 (the therapeutic trial window).Between Jan 18, 2010, and July 25, 2022, 27 285 participants were recruited to RaDaR. Median follow-up time from diagnosis was 9·6 years (IQR 5·9-16·7). RaDaR participants had significantly higher 5-year cumulative incidence of kidney failure than 2·81 million UK patients with all-cause chronic kidney disease (28% vs 1%; p Background Methods Findings Interpretation Funding</p