Particulate Matter and Albuminuria, Glomerular Filtration Rate, and Incident CKD.
Clin J Am Soc Nephrol
; 15(3): 311-319, 2020 03 06.
Article
in En
| MEDLINE
| ID: mdl-32108020
ABSTRACT
BACKGROUND AND OBJECTIVES:
Exposure to particulate matter (PM) <2.5 µm in aerodynamic diameter (PM2.5) has been linked to detrimental health effects. This study aimed to describe the relationship between long-term PM2.5 exposure and kidney disease, including eGFR, level of albuminuria, and incident CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The study included 10,997 participants from the Atherosclerosis Risk in Communities cohort who were followed from 1996-1998 through 2016. Monthly mean PM2.5 concentrations (µg/m3) were estimated at geocoded participant addresses using geographic information system-based, spatiotemporal generalized additive mixed models-including geospatial covariates such as land use-and then averaged over the 12-month period preceding participant examination. Covariate-adjusted, cross-sectional associations of PM2.5, baseline eGFR, and urinary albumin-creatinine ratio (UACR) were estimated using linear regression. PM2.5 and incident CKD (defined as follow-up eGFR <60 ml/min per 1.73 m2 with ≥25% eGFR decline relative to baseline, CKD-related hospitalization or death based on International Classification of Diseases 9/10 codes, or development of ESKD) associations were estimated using Cox proportional hazards regression. Modeling was stratified by study site, and stratum-specific estimates were combined using random-effects meta-analyses.RESULTS:
Baseline mean participant age was 63 (±6) years and eGFR was 86 (±16) ml/min per 1.73 m2. There was no significant PM2.5-eGFR association at baseline. Each 1-µg/m3 higher annual average PM2.5 was associated with higher UACR after adjusting for demographics, socioeconomic status, and clinical covariates (percentage difference, 6.6%; 95% confidence interval [95% CI], 2.6% to 10.7%). Each 1-µg/m3 higher annual average PM2.5 was associated with a significantly higher risk of incident CKD (hazard ratio, 1.05; 95% CI, 1.01 to 1.10).CONCLUSIONS:
Exposure to higher annual average PM2.5 concentrations was associated with a higher level of albuminuria and higher risk for incident CKD in a community-based cohort.Key words
ARIC; International Classification of Diseases; air pollution; albumin; albuminuria; atherosclerosis; chronic kidney disease; chronic kidney failure; chronic renal insufficiency; cohort studies; confidence intervals; creatinine; cross-sectional studies; demography; epidemiology and outcomes; follow-up studies; geographic information systems; glomerular filtration rate; hospitalization; humans; kidney function tests; linear models; particulate matter; social class
Full text:
1
Database:
MEDLINE
Main subject:
Air Pollutants
/
Air Pollution
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Albuminuria
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Renal Insufficiency, Chronic
/
Particulate Matter
/
Glomerular Filtration Rate
/
Kidney
Type of study:
Clinical_trials
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Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Aged
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Female
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Humans
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Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Clin J Am Soc Nephrol
Journal subject:
NEFROLOGIA
Year:
2020
Type:
Article