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


ABSTRACT:

Background and objectives

Exposure to particulate matter (PM) <2.5 ?m 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 (?g/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-?g/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-?g/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.

SUBMITTER: Blum MF 

PROVIDER: S-EPMC7057299 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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

Blum Matthew F MF   Surapaneni Aditya A   Stewart James D JD   Liao Duanping D   Yanosky Jeff D JD   Whitsel Eric A EA   Power Melinda C MC   Grams Morgan E ME  

Clinical journal of the American Society of Nephrology : CJASN 20200227 3


<h4>Background and objectives</h4>Exposure to particulate matter (PM) <2.5 <i>μ</i>m in aerodynamic diameter (PM<sub>2.5</sub>) has been linked to detrimental health effects. This study aimed to describe the relationship between long-term PM<sub>2.5</sub> exposure and kidney disease, including eGFR, level of albuminuria, and incident CKD.<h4>Design, setting, participants, & measurements</h4>The study included 10,997 participants from the Atherosclerosis Risk in Communities cohort who were follow  ...[more]

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