Abstract
BACKGROUND: Chronic kidney disease (CKD) is a serious global public health challenge, but there is limited information on the connection between air pollution and risk of CKD.
OBJECTIVE: The aim of this study was to investigate the association between long-term exposure to particulate matter (PM) with an aerodynamic diameter of less than 2.5 μm (PM2.5 ) and the development of CKD in a large cohort.
METHODS : A total of 100,629 nonCKD Taiwanese residents age 20 y or above were included in this study between 2001 and 2014. Ambient PM2.5 concentration was estimated at each participant’s address using a satellite-based spatiotemporal model. Incident CKD cases were identified by an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2 . We collected information on a wide range of potential confounders/modifiers during the medical examinations. Cox proportional hazard regression was applied to calculate hazard ratios (HRs).
RESULTS: During the follow-up, 4,046 incident CKD cases were identified, and the incidence rate was 6.24 per 1,000 person-years. In contrast with participants with the first quintile exposure of PM2.5 , participants with the fourth and fifth quintiles exposure of PM2.5 had increased risk of CKD development, adjusting for age, sex, educational level, smoking, drinking, body mass index, systolic blood pressure, fasting glucose, total cholesterol, and self-reported heart disease or stroke, with an HR [95% confidence interval (CI)] of 1.11 (1.02, 1.22) and 1.15 (1.05, 1.26), respectively. A significant concentration–response trend was observed (p < 0:001). Every 10 lg/m3 increment in the PM2.5 concentration was associated with a 6% higher risk of developing CKD (HR: 1.06, 95% CI: 1.02, 1.10). Sensitivity and stratified analyses yielded similar results.
CONCLUSIONS: Long-term exposure to ambient PM2.5 was associated with an increased risk of CKD development. Our findings reinforce the urgency to develop global strategies of air pollution reduction to prevent CKD.
OBJECTIVE: The aim of this study was to investigate the association between long-term exposure to particulate matter (PM) with an aerodynamic diameter of less than 2.5 μm (PM2.5 ) and the development of CKD in a large cohort.
METHODS : A total of 100,629 nonCKD Taiwanese residents age 20 y or above were included in this study between 2001 and 2014. Ambient PM2.5 concentration was estimated at each participant’s address using a satellite-based spatiotemporal model. Incident CKD cases were identified by an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2 . We collected information on a wide range of potential confounders/modifiers during the medical examinations. Cox proportional hazard regression was applied to calculate hazard ratios (HRs).
RESULTS: During the follow-up, 4,046 incident CKD cases were identified, and the incidence rate was 6.24 per 1,000 person-years. In contrast with participants with the first quintile exposure of PM2.5 , participants with the fourth and fifth quintiles exposure of PM2.5 had increased risk of CKD development, adjusting for age, sex, educational level, smoking, drinking, body mass index, systolic blood pressure, fasting glucose, total cholesterol, and self-reported heart disease or stroke, with an HR [95% confidence interval (CI)] of 1.11 (1.02, 1.22) and 1.15 (1.05, 1.26), respectively. A significant concentration–response trend was observed (p < 0:001). Every 10 lg/m3 increment in the PM2.5 concentration was associated with a 6% higher risk of developing CKD (HR: 1.06, 95% CI: 1.02, 1.10). Sensitivity and stratified analyses yielded similar results.
CONCLUSIONS: Long-term exposure to ambient PM2.5 was associated with an increased risk of CKD development. Our findings reinforce the urgency to develop global strategies of air pollution reduction to prevent CKD.
| Original language | English |
|---|---|
| Article number | 107002 |
| Journal | Environmental Health Perspectives |
| Volume | 126 |
| Issue number | 10 |
| Online published | 15 Oct 2018 |
| DOIs | |
| Publication status | Published - Oct 2018 |
| Externally published | Yes |
Funding
This study is in part supported by the Environmental Health Research Fund of the Chinese University of Hong Kong (7104946). Z.Z. is in part supported by the PhD Studentship of the Chinese University of Hong Kong. H.B.D. is in part supported by the Faculty Postdoctoral Fellowship Scheme of Faculty of Medicine of the Chinese University of Hong Kong. We would like to thank the MJ Health Research Foundation for authorizing us to use the MJ health data (Authorization code MJHR2015002A).
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