Long-term exposure to high levels of fine particulate matter pollution correlates with CKD
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Long-term exposure to a high levels of a specific air pollution called fine particulate matter can lead to an increased risk of chronic kidney disease in China, according to data published in the American Journal of Kidney Diseases.
Further, the association was stronger in environments with high humidity.
“China has the highest number of patients with CKD in the world, with 132.3 million in 2017. Globally, approximately 17% [to] 20% of the CKD burden has been attributed to PM2.5 pollution, which may potentially be modified at the individual and population levels,” Jing-wen Duan, MD, from the Health Management Center, Clinical Research Center at Central South University in China, and colleagues wrote. “Although epidemiologic and clinical studies have found an association between ambient PM2.5 and increased risk of CKD, there are still some uncertainties because little evidence comes from regions with severe air pollution, such as China, where the PM2.5 pollution is [fivefold to tenfold] higher than the limit of 10 µg /m3 set by the World Health Organization.”
In a prospective cohort study, researchers examined 72,425 participants without CKD from 121 counties in Hunan Province, China. Participants completed baseline examination between 2005 and 2017, and the follow-up period ended in 2018.
With incident CKD serving as the primary outcome, researchers considered annual mean PM2.5 concentration at each participant’s place of residence. According to the study, this concentration was measured with a long-term, full-coverage, high-resolution and high-quality dataset of ground-level air pollutants in China.
Using Cox proportional hazard models, researchers identified the independent association of PM2.5 with incident CKD, as well as the joint correlation of PM2.5 with temperature or humidity, on the progression of PM2.5-related CKD. Additionally, researchers conducted restricted cube splines to model exposure-response relationships.
A total of 2,188 participants developed CKD during a median follow-up of 3.79 years. Analyses revealed PM2.5 exposure correlated with incident CKD with an adjusted hazard ratio of 1.71 per 10 µg /m3 greater long-term exposure. Researchers identified multiplicative interactions between PM2.5 and humidity or temperature on the development of CKD. However, researchers only observed an additive interaction for humidity.
“Our findings suggest that long-term exposure to high levels of ambient PM2.5 significantly increased the risk of CKD in mainland China, especially in terms of cumulative average PM2.5. The associations of PM2.5 and incident CKD were greater in high-humidity environments,” Duan and colleagues wrote. “These findings support the recommendation that reducing PM2.5 pollution should be a priority to decrease the burden of associated health risks, including CKD.”
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