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Particulate Matter and Albuminuria, Glomerular Filtration Rate, and Incident CKD.

Authors
  • Blum, Matthew F1
  • Surapaneni, Aditya2
  • Stewart, James D3
  • Liao, Duanping4
  • Yanosky, Jeff D4
  • Whitsel, Eric A3, 5
  • Power, Melinda C6
  • Grams, Morgan E2, 7
  • 1 Department of Medicine, School of Medicine, and [email protected]
  • 2 Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland.
  • 3 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
  • 4 Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
  • 5 Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; and.
  • 6 Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC.
  • 7 Division of Nephrology.
Type
Published Article
Journal
Clinical Journal of the American Society of Nephrology
Publisher
American Society of Nephrology
Publication Date
Mar 06, 2020
Volume
15
Issue
3
Pages
311–319
Identifiers
DOI: 10.2215/CJN.08350719
PMID: 32108020
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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). 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. Copyright © 2020 by the American Society of Nephrology.

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