TY - JOUR
T1 - Associations of ambient coarse particulate matter, nitrogen dioxide, and carbon monoxide with the risk of kidney disease
T2 - a cohort study
AU - Bowe, Benjamin
AU - Xie, Yan
AU - Li, Tingting
AU - Yan, Yan
AU - Xian, Hong
AU - Al-Aly, Ziyad
N1 - Publisher Copyright:
© 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2017/10
Y1 - 2017/10
N2 - Background Experimental evidence and preliminary clinical evidence suggest that environmental air pollution adversely effects kidney health. Previous work has examined the association between fine particulate matter and risk of kidney disease; however, the association between ambient coarse particulate matter (PM10; ≤10 μm in aerodynamic diameter), nitrogen dioxide (NO2), and carbon monoxide (CO) and risk of incident chronic kidney disease, chronic kidney disease progression, and end-stage renal disease is not clear. Methods We merged multiple large databases, including those of the Environmental Protection Agency and the Department of Veterans Affairs, to build a cohort of US veterans, and used survival models to evaluate the association between PM10, NO2, and CO concentrations and risk of incident estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1·73 m2, incident chronic kidney disease, eGFR decline of 30% or more, and end-stage renal disease. We treated exposure as time-varying when it was updated annually and as cohort participants moved. Findings Between Oct 1, 2003, and Sept 30, 2012, 2 010 398 cohort participants were followed up over a median of 8·52 years (IQR 8·05–8·80). An increased risk of eGFR of less than 60 mL/min per 1·73 m2 was associated with an IQR increase in concentrations of PM10 (hazard ratio 1·07, 95% CI 1·06–1·08), NO2 (1·09, 1·08–1·10), and CO (1·09, 1·08–1·10). An increased risk of incident chronic kidney disease was associated with an IQR increase in concentrations of PM10 (1·07, 1·05–1·08), NO2 (1·09, 1·08–1·11), and CO (1·10, 1·08–1·11). An increased risk of an eGFR decline of 30% or more was associated with an IQR increase in concentrations of PM10 (1·08, 1·07–1·09), NO2 (1·12, 1·10–1·13), and CO (1·09, 1·08–1·10). An increased risk of end-stage renal disease was associated with an IQR increase in concentrations of PM10 (1·09, 1·06–1·12), NO2 (1·09, 1·06–1·12), and CO (1·05, 1·02–1·08). Spline analyses suggested a monotonic increasing association between PM10, NO2, and CO concentrations and risk of kidney outcomes. Interpretation Environmental exposure to higher concentrations of PM10, NO2, and CO is associated with increased risk of incident chronic kidney disease, eGFR decline, and end-stage renal disease. Funding US Department of Veterans Affairs.
AB - Background Experimental evidence and preliminary clinical evidence suggest that environmental air pollution adversely effects kidney health. Previous work has examined the association between fine particulate matter and risk of kidney disease; however, the association between ambient coarse particulate matter (PM10; ≤10 μm in aerodynamic diameter), nitrogen dioxide (NO2), and carbon monoxide (CO) and risk of incident chronic kidney disease, chronic kidney disease progression, and end-stage renal disease is not clear. Methods We merged multiple large databases, including those of the Environmental Protection Agency and the Department of Veterans Affairs, to build a cohort of US veterans, and used survival models to evaluate the association between PM10, NO2, and CO concentrations and risk of incident estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1·73 m2, incident chronic kidney disease, eGFR decline of 30% or more, and end-stage renal disease. We treated exposure as time-varying when it was updated annually and as cohort participants moved. Findings Between Oct 1, 2003, and Sept 30, 2012, 2 010 398 cohort participants were followed up over a median of 8·52 years (IQR 8·05–8·80). An increased risk of eGFR of less than 60 mL/min per 1·73 m2 was associated with an IQR increase in concentrations of PM10 (hazard ratio 1·07, 95% CI 1·06–1·08), NO2 (1·09, 1·08–1·10), and CO (1·09, 1·08–1·10). An increased risk of incident chronic kidney disease was associated with an IQR increase in concentrations of PM10 (1·07, 1·05–1·08), NO2 (1·09, 1·08–1·11), and CO (1·10, 1·08–1·11). An increased risk of an eGFR decline of 30% or more was associated with an IQR increase in concentrations of PM10 (1·08, 1·07–1·09), NO2 (1·12, 1·10–1·13), and CO (1·09, 1·08–1·10). An increased risk of end-stage renal disease was associated with an IQR increase in concentrations of PM10 (1·09, 1·06–1·12), NO2 (1·09, 1·06–1·12), and CO (1·05, 1·02–1·08). Spline analyses suggested a monotonic increasing association between PM10, NO2, and CO concentrations and risk of kidney outcomes. Interpretation Environmental exposure to higher concentrations of PM10, NO2, and CO is associated with increased risk of incident chronic kidney disease, eGFR decline, and end-stage renal disease. Funding US Department of Veterans Affairs.
UR - http://www.scopus.com/inward/record.url?scp=85042610714&partnerID=8YFLogxK
U2 - 10.1016/S2542-5196(17)30117-1
DO - 10.1016/S2542-5196(17)30117-1
M3 - Article
C2 - 29851625
AN - SCOPUS:85042610714
SN - 2542-5196
VL - 1
SP - e267-e276
JO - The Lancet Planetary Health
JF - The Lancet Planetary Health
IS - 7
ER -