Air pollution linked to myocardial fibrosis in patients with CKD
Increased exposure to air pollution may lead to higher risk for myocardial fibrosis in patients with chronic kidney disease, according to a speaker at ASN Kidney Week.
“We know that air pollution, especially particulate matter (PM), is a major risk factor for development of cardiovascular and CKD. Nine million of total deaths are directly attributable to environmental pollution,” Hafsa Tariq, MD, from University Hospitals Cleveland Medical Center, Case Western Reserve University, said. “When we talk about air pollution, we are mostly concerned about PM, especially PM10 and PM2.5. The numbers refer to the size of the particle. PM2.5, due to its small size, is inhaled deeply in the alveoli and activates local cells like macrophages and endothelial cells.”
“Our study aims to assess whether Galectin 3 level is associated with air pollution, exposure and hypertensive patients with and without chronic kidney disease,” Tariq said.
Researchers analyzed 1,019 patients from the Systolic Blood Pressure Intervention Trial (SPRINT) with Galectin 3 levels available at baseline. The correlation between air pollution and Galectin 3 at baseline and 2 years was determined by multivariable linear regression models adjusted for age, sex, race, eGFR, Framingham risk score, BMI and randomization assignment.
Following analyses, the mean PM2.5 was 9.6 microgram/m3. The median (IQR) Galectin 3 level was 14.4 ng/mL. Multivariable models revealed no correlation between PM2.5 and Galectin 3 at baseline or longitudinal change, however there was a statistically significant change observed in the subgroup of participants with CKD (n=201).
“We do think that the strength of our study is the simultaneous assessment of Galectin 3 and PM2.5 in patients with high cardiovascular risk with and without CKD, and longitudinal measurement of Galectin 3 in patients with and without CKD. However, we do acknowledge that there is lack of histological and imaging data of myocardial fibrosis,” Tariq said. “We were unable to adjust for socioeconomic status, which is something that we plan to do in future.”
She added, “In conclusion, air pollution may be associated with worsening myocardial fibrosis as evidenced by increasing levels of Galectin 3 in individuals with preexisting CKD.”
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Tariq H, et al. Galectin 3 and air pollution in hypertensive patients with and without CKD. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).