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Clinical Epidemiology
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Long-Term Exposure to Ambient PM2.5 and Increased Risk of CKD Prevalence in China

Guoxing Li, Jing Huang, Jinwei Wang, Minghui Zhao, Yang Liu, Xinbiao Guo, Shaowei Wu and Luxia Zhang
JASN February 2021, 32 (2) 448-458; DOI: https://doi.org/10.1681/ASN.2020040517
Guoxing Li
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
2Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
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Jing Huang
2Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
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Jinwei Wang
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
3Institute of Nephrology, Peking University, Beijing, China
4Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Peking University, Ministry of Education of the People’s Republic of China, Beijing, China
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Minghui Zhao
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
3Institute of Nephrology, Peking University, Beijing, China
4Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Peking University, Ministry of Education of the People’s Republic of China, Beijing, China
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Yang Liu
5Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Xinbiao Guo
2Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
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Shaowei Wu
2Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
6Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, Beijing, China
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Luxia Zhang
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
3Institute of Nephrology, Peking University, Beijing, China
7Key Laboratory of Renal Disease, Ministry of Health of the People’s Republic of China, Beijing, China
8National Institutes of Health Data Science at Peking University, Beijing, China
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Significance Statement

Exposure to an air pollutant, fine particulate matter (PM2.5), is an important environmental risk factor for cardiopulmonary disease. However, minimal data exist on how exposure to high PM2.5 levels, such as in areas of mainland China, may affect CKD risk. In their analysis of data from a large survey of Chinese adults, the authors demonstrate significant associations between long-term exposure to high ambient levels of PM2.5 and an increased risk of CKD prevalence and albuminuria. These associations were significantly stronger in urban areas, among males, among individuals <65 years, and among those with comorbidities. The study’s findings offer insight for target population protection and provide evidence for policy makers and public health practices to reduce the CKD risk associated with ambient PM2.5 pollution.

Abstract

Background Fine particulate matter (PM2.5) is an important environmental risk factor for cardiopulmonary diseases. However, the association between PM2.5 and risk of CKD remains under-recognized, especially in regions with high levels of PM2.5, such as China.

Methods To explore the association between long-term exposure to ambient PM2.5 and CKD prevalence in China, we used data from the China National Survey of CKD, which included a representative sample of 47,204 adults. We estimated annual exposure to PM2.5 before the survey date at each participant’s address, using a validated, satellite-based, spatiotemporal model with a 10 km×10 km resolution. Participants with eGFR <60 ml/min per 1.73 m2 or albuminuria were defined as having CKD. We used a logistic regression model to estimate the association and analyzed the influence of potential modifiers.

Results The 2-year mean PM2.5 concentration was 57.4 μg/m3, with a range from 31.3 to 87.5 μg/m3. An increase of 10 μg/m3 in PM2.5 was positively associated with CKD prevalence (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.22 to 1.35) and albuminuria (OR, 1.39; 95% CI, 1.32 to 1.47). Effect modification indicated these associations were significantly stronger in urban areas compared with rural areas, in males compared with females, in participants aged <65 years compared with participants aged ≥65 years, and in participants without comorbid diseases compared with those with comorbidities.

Conclusions These findings regarding the relationship between long-term exposure to high ambient PM2.5 levels and CKD in the general Chinese population provide important evidence for policy makers and public health practices to reduce the CKD risk posed by this pollutant.

  • chronic kidney disease
  • prevalence
  • ambient PM2.5
  • long-term exposure
  • Copyright © 2021 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 32 (2)
Journal of the American Society of Nephrology
Vol. 32, Issue 2
February 2021
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Long-Term Exposure to Ambient PM2.5 and Increased Risk of CKD Prevalence in China
Guoxing Li, Jing Huang, Jinwei Wang, Minghui Zhao, Yang Liu, Xinbiao Guo, Shaowei Wu, Luxia Zhang
JASN Feb 2021, 32 (2) 448-458; DOI: 10.1681/ASN.2020040517

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Long-Term Exposure to Ambient PM2.5 and Increased Risk of CKD Prevalence in China
Guoxing Li, Jing Huang, Jinwei Wang, Minghui Zhao, Yang Liu, Xinbiao Guo, Shaowei Wu, Luxia Zhang
JASN Feb 2021, 32 (2) 448-458; DOI: 10.1681/ASN.2020040517
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More in this TOC Section

  • Effect of Kidney Function on Relationships between Lifestyle Behaviors and Mortality or Cardiovascular Outcomes: A Pooled Cohort Analysis
  • Subtyping CKD Patients by Consensus Clustering: The Chronic Renal Insufficiency Cohort (CRIC) Study
  • Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention
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