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Cui J, Chen W, Zhang D, Lu M, Huang Z, Yi B. Metformin attenuates PM 2.5-induced oxidative stress by inhibiting the AhR/CYP1A1 pathway in proximal renal tubular epithelial cells. Toxicol Mech Methods 2024:1-13. [PMID: 39034811 DOI: 10.1080/15376516.2024.2378296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024]
Abstract
The harmful effects of PM2.5 on human health, including an increased risk of chronic kidney disease (CKD), have raised a lot of attention, but the underlying mechanisms are unclear. We used the Shanghai Meteorological and Environmental Animal Exposure System (Shanghai-METAS) to simulate the inhalation of PM2.5 in the real environment and established an animal model by exposing C57BL/6 mice to filtered air (FA) and Particulate Matter (PM2.5) for 8 weeks. PM2.5 impaired the renal function of the mice, and the renal tubules underwent destructive changes. Analysis of NHANES data showed a correlation between reduced kidney function and higher blood levels of PM2.5 components, polychlorinated biphenyls (PCBs) and dioxins, which are Aryl hydrocarbon Receptor (AhR) ligands. PM2.5 exposure induced higher levels of AhR and CYP1A1 and oxidative stress as evidenced by the higher levels of ROS, MDA, and GSSG in kidneys of mice. PM2.5 exposure led to AhR overexpression and nuclear translocation in proximal renal tubular epithelial cells. Inhibition of AhR reduced CYP1A1 expression and PM2.5-increased levels of ROS, MDA and GSSG. Our study suggested metformin can mitigate PM2.5-induced oxidative stress by inhibiting the AhR/CYP1A1 pathway. These findings illuminated the role of AhR/CYP1A1 pathway in PM2.5-induced kidney injury and the protective effect of metformin on PM2.5-induced cellular damage, offering new insights for air pollution-related renal diseases.
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Affiliation(s)
- Jing Cui
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Critical Kidney Disease in Hunan Province, Changsha, Hunan, China
| | - Weilin Chen
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Critical Kidney Disease in Hunan Province, Changsha, Hunan, China
| | - Dongdong Zhang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Critical Kidney Disease in Hunan Province, Changsha, Hunan, China
| | - Mengqiu Lu
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Critical Kidney Disease in Hunan Province, Changsha, Hunan, China
| | - Zhijun Huang
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Critical Kidney Disease in Hunan Province, Changsha, Hunan, China
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bin Yi
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Critical Kidney Disease in Hunan Province, Changsha, Hunan, China
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Leonetti A, Peansukwech U, Charnnarong J, Cha'on U, Suttiprapa S, Anutrakulchai S. Effects of particulate matter (PM2.5) concentration and components on mortality in chronic kidney disease patients: a nationwide spatial-temporal analysis. Sci Rep 2024; 14:16810. [PMID: 39039106 PMCID: PMC11263396 DOI: 10.1038/s41598-024-67642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024] Open
Abstract
Chronic kidney disease (CKD) is a major global public health issue and the leading cause of death in Thailand. This study investigated the spatial-temporal association between PM2.5 and its components (organic carbon, black carbon, dust, sulfate, and sea salt) and CKD mortality in Thailand from 2012 to 2021. The Modern-Era Retrospective analysis for Research and Application version 2 (MERRA-2), a NASA atmospheric satellite model, was assessed for the temporal data of PM2.5 concentration and aerosol components. Spatial resources of 77 provinces were integrated using the Geographical Information System (GIS). Multivariate Poisson regression and Bayesian inference analyses were conducted to explore the effects of PM2.5 on CKD mortality across the provinces. Our analysis included 718,686 CKD-related deaths, resulting in a mortality rate of 1107 cases per 100,000 population where was the highest rate in Northeast region. The average age of the deceased was 72.43 ± 13.10 years, with males comprising 50.46% of the cases. Adjusting for age, sex, underlying diseases, co-morbidities, CKD complications, replacement therapy, population density, and income, each 1 µg/m3 increase in PM2.5, black carbon, dust, sulfate, and organic carbon was significantly associated with increased CKD mortality across 77 provinces. Incidence rate ratios were 1.04 (95% CI 1.03-1.04) for PM2.5, 1.11 (95% CI 1.10-1.13) for black carbon, 1.24 (95% CI 1.22-1.25) for dust, 1.16 (95% CI 1.16-1.17) for sulfate, and 1.05 (95% CI 1.04-1.05) for organic carbon. These findings emphasize the significant impact of PM2.5 on CKD mortality and underscore the need for strategies to reduce PM emissions and manage CKD co-morbidities effectively.
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Affiliation(s)
- Alessia Leonetti
- Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Udomlack Peansukwech
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | | | - Ubon Cha'on
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sutas Suttiprapa
- Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand.
- Anandamahidol Foundation, Bangkok, Thailand.
- Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Jafari Shahri M, Sarkhosh M, Alidadi H, Najafpoor AA, Ghavami V, Baridkazemi S. Assessing the risks associated with indoor and outdoor air quality in relation to the geographic placement of nursing home. Heliyon 2024; 10:e32601. [PMID: 39035529 PMCID: PMC11259808 DOI: 10.1016/j.heliyon.2024.e32601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/26/2024] [Accepted: 06/05/2024] [Indexed: 07/23/2024] Open
Abstract
Indoor air quality significantly impacts the well-being and health of elderly residents in nursing homes. This study was conducted to explore the connection between indoor and outdoor PM (Particulate Matter) concentrations in nursing homes and their association with the facilities' location and construction characteristics. The findings revealed that indoor PM2.5 and PM10 concentrations ranged from 0.2 to 124 μg/m3 and 2-188.4 μg/m3, respectively, which were approximately 12.67 and 1.25 times higher than their outdoor counterparts. A strong correlation (P < 0.05) was identified between indoor PM levels and various factors, including proximity to parks, passenger terminals, and gas stations, as well as building attributes such as single-glazed windows, ceramic floor coverings, and the use of radiators. The risk assessment indicated that carcinogenic risk factors were well within acceptable limits for all nursing homes. However, it's important to note that certain PM components, particularly polycyclic aromatic hydrocarbons (PAH), may have long-term adverse effects on the health of nursing home residents. Even though indoor PM levels met the standards established by the U.S. Environmental Protection Agency (USEPA) for particulate matter risk assessments, the study emphasized that even low levels of indoor air pollutants can affect the health and well-being of older adults, particularly considering the increased vulnerability associated with aging. Consequently, the study underscores the importance of nursing home location selection and the regular monitoring of particulate matter concentrations. These measures are essential for enhancing air quality within nursing homes, ultimately contributing to the improved well-being and health of their residents.
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Affiliation(s)
- Mojgan Jafari Shahri
- Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Sarkhosh
- Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Alidadi
- Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Asghar Najafpoor
- Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Ghavami
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sima Baridkazemi
- Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Liang KH, Colombijn JMT, Verhaar MC, Ghannoum M, Timmermans EJ, Vernooij RWM. The general external exposome and the development or progression of chronic kidney disease: A systematic review and meta-analyses. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 358:124509. [PMID: 38968981 DOI: 10.1016/j.envpol.2024.124509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 06/07/2024] [Accepted: 07/03/2024] [Indexed: 07/07/2024]
Abstract
The impact of environmental risk factors on chronic kidney disease (CKD) remains unclear. This systematic review aims to provide an overview of the literature on the association between the general external exposome and CKD development or progression. We searched MEDLINE and EMBASE for case-control or cohort studies, that investigated the association of the general external exposome with a change in eGFR or albuminuria, diagnosis or progression of CKD, or CKD-related mortality. The risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. Summary effect estimates were calculated using random-effects meta-analyses. Most of the 66 included studies focused on air pollution (n = 33), e.g. particulate matter (PM) and nitric oxides (NOx), and heavy metals (n = 21) e.g. lead and cadmium. Few studies investigated chemicals (n = 7) or built environmental factors (n = 5). No articles on other environment factors such as noise, food supply, or urbanization were found. PM2.5 exposure was associated with an increased CKD and end-stage kidney disease incidence, but not with CKD-related mortality. There was mixed evidence regarding the association of NO2 and PM10 on CKD incidence. Exposure to heavy metals might be associated with an increased risk of adverse kidney outcomes, however, evidence was inconsistent. Studies on effects of chemicals or built environment on kidney outcomes were inconclusive. In conclusion, prolonged exposure to PM2.5 is associated with an increased risk of CKD incidence and progression to kidney failure. Current studies predominantly investigate the exposure to air pollution and heavy metals, whereas chemicals and the built environment remains understudied. Substantial heterogeneity and mixed evidence were found across studies. Therefore, long-term high-quality studies are needed to elucidate the impact of exposure to chemicals or other (built) environmental factors and CKD.
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Affiliation(s)
- Kate H Liang
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Julia M T Colombijn
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Marianne C Verhaar
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marc Ghannoum
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; National Poison Information Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Robin W M Vernooij
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Dahman L, Gauthier V, Camier A, Bigna JJ, Glowacki F, Amouyel P, Dauchet L, Hamroun A. Air pollution and kidney cancer risk: a systematic review and meta-analysis. J Nephrol 2024:10.1007/s40620-024-01984-x. [PMID: 38913266 DOI: 10.1007/s40620-024-01984-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/30/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Although several risk factors of kidney cancer have already been well-addressed, many remain underappreciated, such as chronic exposure to air pollution. This systematic review and meta-analysis aims to assess the association between air pollutant exposure and the risk of kidney cancer. METHODS With an exhaustive search equation including keywords related to air pollution and kidney cancer on EMBASE, PubMed, Web of science, Cochrane Library and CINAHL database, we identified all relevant articles published before March 23rd, 2023 (Prospero registration number: CRD42020187956). Using random-effects meta-analysis, we present pooled hazard ratios (with their respective 95% confidence interval) associated with a 10 µg/m3 increase in each pollutant level. Heterogeneity was quantified by the I2 statistic. Risks of methodological and publication bias were also both assessed using appropriate tools. RESULTS Of the 1919 records identified, our review included 19 articles (13 cohort, 5 registry-based and 1 case-control studies), of which 9 were suitable for the meta-analysis. We found a significantly increased risk of kidney cancer incidence for a 10 μg/m3 elevation of both particulate matter of less than 10 µm (PM10) (HR = 1.29 [1.10; 1.51], I2 = 0%, p = 0.002) and nitrogen dioxide (NO2) (HR = 1.10 [1.03; 1.18], I2 = 20%, p = 0.004). Secondary analyses also suggest an increased risk of kidney cancer-related morbidity-mortality associated with PM10 exposure. CONCLUSIONS Overall, our findings suggest a potential association between exposure to increased levels of PM10 and NO2 and the risk of kidney cancer. These results should nonetheless be interpreted with caution due to the limited number of included studies and their significant risk of methodological bias.
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Affiliation(s)
- Lina Dahman
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
- Faculté de Médecine, Université Catholique de Lille, Lille, France
| | - Victoria Gauthier
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France
| | | | - Jean Joel Bigna
- Département de Santé Publique, Epidémiologie, Institut Pasteur du Cameroun, Yaoundé, Cameroun
| | | | - Philippe Amouyel
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France
| | - Luc Dauchet
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France
| | - Aghiles Hamroun
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France.
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France.
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Zhang S, Tang H, Zhou M, Pan L. Sexual dimorphism association of combined exposure to volatile organic compounds (VOC) with kidney damage. ENVIRONMENTAL RESEARCH 2024; 258:119426. [PMID: 38879106 DOI: 10.1016/j.envres.2024.119426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Epidemiological evidence emphasizes air pollutants' role in chronic kidney disease (CKD). Volatile organic compounds (VOCs) contribute to air pollution, yet research on VOCs and kidney damage, especially gender disparities, is limited. METHODS This study analyzed NHANES data to explore associations between urinary VOC metabolite mixtures (VOCMs) and key kidney-related parameters: estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), chronic kidney disease (CKD), and albuminuria. Mediation analyses assessed the potential mediating roles of biological aging (BA) and serum albumin in VOCM mixtures' effects on kidney damage. Sensitivity analyses were also conducted. RESULTS The mixture analysis unveiled a noteworthy positive association between VOCM mixtures and the risk of developing CKD, coupled with a significant negative correlation with eGFR within the overall participant cohort. These findings remained consistent when examining the female subgroup. However, among male participants, no significant link emerged between VOCM mixtures and CKD or eGFR. Furthermore, in both the overall and female participant groups, there was an absence of a significant correlation between VOCM mixtures and either ACR or albuminuria. On the other hand, in male participants, while no significant correlation was detected with albuminuria, a significant positive correlation was observed with ACR. Pollutant analysis identified potential links between kidney damage and 1,3-butadiene, toluene, ethylbenzene, styrene, xylene, acrolein, crotonaldehyde and propylene oxide. Mediation analyses suggested that BA might partially mediate the relationship between VOCM mixtures and kidney damage. CONCLUSION The current findings highlight the widespread exposure to VOCs among the general U.S. adult population and indicate a potential correlation between exposure to VOC mixtures and compromised renal function parameters, with notable gender disparities. Females appear to exhibit greater sensitivity to impaired renal function resulting from VOCs exposure. Anti-aging treatments may offer some mitigation against kidney damage due to VOCs exposure.
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Affiliation(s)
- Shuai Zhang
- Department of Male Reproductive Health, Lianyungang Maternal and Child Health Hospital, Qindongmen Avenue, Haizhou District, Lianyungang, 222000, China; Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Qindongmen Avenue, Haizhou District, Lianyungang, 222000, China.
| | - Hanhan Tang
- Graduate School of Xuzhou Medical University, Xuzhou Medical University, No. 209, Tongshan Road, Xuzhou, 221004, China
| | - Minglian Zhou
- Department of Male Reproductive Health, Lianyungang Maternal and Child Health Hospital, Qindongmen Avenue, Haizhou District, Lianyungang, 222000, China; Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Qindongmen Avenue, Haizhou District, Lianyungang, 222000, China
| | - Linqing Pan
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Qindongmen Avenue, Haizhou District, Lianyungang, 222000, China
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Ma H, Liang W, Han A, Zhang Q, Gong S, Bai Y, Gao D, Xiang H, Wang X. Ambient particulate matter and renal function decline in people with HIV/AIDS. AIDS 2024; 38:713-721. [PMID: 38016165 DOI: 10.1097/qad.0000000000003802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE We aimed to explore the effect of particulate matter exposure on renal function in people with HIV/AIDS (PWHA). METHODS A total of 37 739 repeated measurements were conducted on eGFR levels, serum creatinine (Scr), and the triglyceride-glucose (TyG) index in 6958 PWHAs. The relationship between 1 and 28 day moving averages of particulate matter concentrations with Scr and eGFR was assessed using linear mixed-effects models. Modified Poisson regression models were employed to assess the associations of cumulative particulate matter exposure with the incidence of chronic kidney disease (CKD). Mediation analyses were used to examine the role of TyG index. RESULTS Short-term exposure to particulate matter was related to reduced renal function. The strongest associations between exposure to particulate matter (PM) 1 , PM 2.5 , and PM 10 and percentage changes in eGFR were observed at 7-day moving average exposure windows, with a respective decrease of 0.697% (-1.008%, -0.386%), 0.429% (-0.637%, -0.220%), and 0.373% (-0.581%, -0.164%) per IQR increment. Long-term exposure to PM 1 , PM 2.5 , and PM 10 was positively linked with the incidence of CKD, with each IQR increment corresponding to fully adjusted RRs (95% CIs) of 1.631 (1.446-1.839), 1.599 (1.431-1.787), and 1.903 (1.665-2.175), respectively. TyG index-mediated 8.87, 8.88, and 7.58% of the relationship between cumulative exposure to PM 1 , PM 2.5 , and PM 10 and increased risk of CKD, respectively. CONCLUSION Exposure to particulate matter among PWHAs is linked to reduced renal function, potentially contributing to increased CKD incidence, where the TyG index might serve as a partial mediator.
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Affiliation(s)
- Hongfei Ma
- Wuhan Center for Disease Control and Prevention
| | - Wei Liang
- School of Public Health, Wuhan University
| | - Aojing Han
- School of Public Health, Wuhan University
| | - Qian Zhang
- Qingshan District Center for Disease Control and Prevention
| | - Shun Gong
- Hongshan District Center for Disease Control and Prevention
| | - Yang Bai
- Jiangan District Center for Disease Control and Prevention
| | - Daiming Gao
- Xinzhou District Center for Disease Control and Prevention, Wuhan, China
| | - Hao Xiang
- School of Public Health, Wuhan University
| | - Xia Wang
- Wuhan Center for Disease Control and Prevention
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Kim E, Huh H, Mo Y, Park JY, Jung J, Lee H, Kim S, Kim DK, Kim YS, Lim CS, Lee JP, Kim YC, Kim H. Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study. BMC Nephrol 2024; 25:74. [PMID: 38418953 PMCID: PMC10900590 DOI: 10.1186/s12882-024-03500-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Epidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD. METHODS We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed. RESULTS In the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3. The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014-1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035-1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044-1.054) at the district unit and 1.04 (95%CI: 1.031-1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008-1.017) for administrative districts and 1.04 (95% confidence interval: 1.031-1.05) for individual addresses. CONCLUSIONS This study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment.
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Affiliation(s)
- Ejin Kim
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, Room 708, Building 220, Gwanak-Ro Gwanak-Gu, Seoul, 08826, Republic of Korea
- Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hyuk Huh
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yongwon Mo
- Department of Landscape Architecture, Yeungnam University, Gyeongsan, Republic of Korea
| | - Jae Yoon Park
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Gyeonggi-Do, Republic of Korea
| | - Jiyun Jung
- Data Management and Statistics Institute, Dongguk University Ilsan Hospital, Ilsan, Republic of Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Daehak-Ro, Jongno-Gu, 101, Seoul, Republic of Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Daehak-Ro, Jongno-Gu, 101, Seoul, Republic of Korea
- Kidney Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Daehak-Ro, Jongno-Gu, 101, Seoul, Republic of Korea
- Kidney Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Daehak-Ro, Jongno-Gu, 101, Seoul, Republic of Korea.
| | - Ho Kim
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, Room 708, Building 220, Gwanak-Ro Gwanak-Gu, Seoul, 08826, Republic of Korea.
- Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, Seoul, Republic of Korea.
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Yang C, Wang W, Wang F, Wang Y, Zhang F, Liang Z, Liang C, Wang J, Ma L, Li P, Li S, Zhang L. Ambient PM 2.5 components and prevalence of chronic kidney disease: a nationwide cross-sectional survey in China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:70. [PMID: 38353840 DOI: 10.1007/s10653-024-01867-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES Chronic kidney disease (CKD) is a global public health concern, and accumulating evidence has indicated that air pollution increases the odds of CKD. However, a limited number of studies have examined the long-term effects of ambient fine particulate matter (PM2.5) components on the risk of CKD among general population; thus, major knowledge gaps remain. METHODS Using data from a nationwide representative cross-sectional survey in China and a validated PM2.5 composition dataset, we established generalized linear models to quantify the association between five major components of PM2.5 and CKD prevalence. RESULTS There were significant associations between long-term exposure to three PM2.5 components [including black carbon (BC), sulfate (SO42-), organic matter (OM)] and increased odds of CKD prevalence. Along with an interquartile range (IQR) increment in BC (3.3 μg/m3), SO42- (9.7 μg/m3), and OM (16.2 μg/m3) at a 4-year moving average, the odds ratios (ORs) for CKD prevalence were 1.28 (95% CI 1.07, 1.54), 1.23 (95% CI 1.03, 1.45), and 1.23 (95% CI 1.02, 1.47), respectively. We did not detect any significant association of the other two PM2.5 components [nitrate (NO3-) or ammonium (NH4+)] with CKD prevalence. Stratified analyses revealed no differences (P ≥ 0.05) in the effect estimates of subgroups based on administrative region, sex, age, and other demographic characteristics. For instance, along with an IQR increment in BC at a 4-year moving average, the ORs of CKD prevalence among males and females were 1.30 (95% CI 0.98, 1.73) and 1.29 (95% CI 1.01, 1.65), respectively. The odds of CKD were generally higher with increasing PM2.5 composition concentration. CONCLUSIONS Our study demonstrated that long-term exposure to specific PM2.5 components including BC, SO42-, and OM increased CKD risk in the general population. This study could provide new insights into source-directed PM2.5 control and CKD prevention.
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Affiliation(s)
- Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
| | - Fulin Wang
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 100191, China
| | - Yueyao Wang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Feifei Zhang
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 100191, China
| | - Ze Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Chenyu Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China
| | - Lin Ma
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China
| | - Shuangcheng Li
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China.
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China.
- National Institute of Health Data Science at Peking University, Beijing, 100191, China.
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10
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Peng S, Yin X, Chen G, Sun J, Chen B, Zhou Y, Li Z, Liu F, Xiang H. Long-term exposure to varying-sized particulate matters and kidney disease in middle-aged and elder adults: A 8-year nationwide cohort study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 911:168621. [PMID: 37977376 DOI: 10.1016/j.scitotenv.2023.168621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
Evidence for the causal relationship of particulate matters (PMs) exposure with kidney disease, especially PM1, PM1-2.5 and PM2.5-10, remained scarce among developing countries with severe pollution. We conducted a longitudinal cohort study involving 13,041 adults with free kidney disease from 150 Chinese counties. PMs concentrations were generated using a well-established satellite-based spatiotemporal model. And the time-varying Cox regression model along with stratified analyses were performed to determine the association and potential modifiers, respectively. We also calculated the population-attributable fraction to evaluate the burden of kidney disease attributable to PMs pollution. Between Jan 2011 and Dec 2018, 985 kidney disease incidents were identified with an incidence rate of 12.69 per 1000 person-years. Significant dose-response relationships were observed for all 5 kinds PMs. Specifically, an increased risk of kidney disease was associated with per 10 μg/m3 increment of PM1 (HR = 1.187, 95%CI: 1.114 to 1.265), PM1-2.5 (1.326, 1.212 to 1.452), PM2.5 (1.197, 1.139 to 1.258), PM2.5-10 (1.297, 1.240 to 1.357), and PM10 (1.137, 1.108 to 1.166). A mixture analysis method of weighted quantile regression model revealed that PM2.5-10 predominated the PMs mixture index (57.1 %), and followed with PM10 (26.4 %). Stratified analyses indicated the elder, overweight persons, smokers, respiratory patients and urban residents were more vulnerable to PMs pollution than their counterparts. Calculated population attributable fractions of kidney disease attributable to PMs pollution was 16.67-39.47 %. Higher PMs pollution was associated with the increased risk of kidney disease development in China. Acceleration of efforts to reduce PMs pollution was therefore urgently needed to alleviate kidney disease burden.
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Affiliation(s)
- Shouxin Peng
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China; Global Health Institute, Wuhan University, Wuhan, Hubei 430071, China
| | - Xiaoyi Yin
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Jinhui Sun
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China; Global Health Institute, Wuhan University, Wuhan, Hubei 430071, China
| | - Bingbing Chen
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China
| | - Yi Zhou
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China
| | - Zhaoyuan Li
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China; Global Health Institute, Wuhan University, Wuhan, Hubei 430071, China
| | - Feifei Liu
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China; Global Health Institute, Wuhan University, Wuhan, Hubei 430071, China
| | - Hao Xiang
- Global Health Department, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China; Global Health Institute, Wuhan University, Wuhan, Hubei 430071, China.
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11
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Ren W, Yang H, Liu W, Zhang S, Yang Y, Yang L, Liu W, Zhang H, He K, Li X, Ge J. Exposure to mixtures of PM 2.5 components and term premature rupture of membranes: a case-crossover study in Shijiazhuang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-13. [PMID: 38269576 DOI: 10.1080/09603123.2024.2308017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
This study aims to explore the acute effects of short-term exposure to PM2.5 components and their mixture on PROM. Counts of hospital admissions due to PROM were collected at the Fourth Hospital of Shijiazhuang. The associations between the PROM and PM2.5 components was examined using a time-stratified case-crossover approach. The overall effects of components on TPROM were examined using the BKMR. During the study period 30,709 cases of PROMwere identified. The relative risks and the 95% CI of TPROM were 1.013 (1.002, 1.028) and 1.015 (1.003, 1.028) associated with per interquartile range increase in nitrate and ammonium ion on the current day and they were 1.007 (1.001, 1.013) and 1.003 (1.000, 1.005) on the previous day. The results from the BKMR models showed a higher risk of TPROM was associated with exposure to mixtures, in which, nitrate and organic matter were the main contributors to the overall effect.
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Affiliation(s)
- Weiyan Ren
- Hebei Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Huangmin Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wencong Liu
- Department of Ultrasonics, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shaochong Zhang
- Department of Medical Records, Shijiazhuang Fourth Hospital, shijiazhuang, China
| | - Yanjing Yang
- Department of Medical Records, Shijiazhuang Fourth Hospital, shijiazhuang, China
| | - Lei Yang
- Hebei Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Wenxuan Liu
- Hebei Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Haijuan Zhang
- Department of Medical Records, Shijiazhuang Fourth Hospital, shijiazhuang, China
| | - Ke He
- Department of Medical Records, Shijiazhuang Fourth Hospital, shijiazhuang, China
| | - Xia Li
- Department of Medical Records, Shijiazhuang Fourth Hospital, shijiazhuang, China
| | - Jun Ge
- Department of Medical Records, Shijiazhuang Fourth Hospital, shijiazhuang, China
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12
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Shang Z, Gao YM, Deng ZL, Wang Y. Long-term exposure to ambient air pollutants and increased risk of end-stage renal disease in patients with type 2 diabetes mellitus and chronic kidney disease: a retrospective cohort study in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:5429-5443. [PMID: 38123768 PMCID: PMC10799089 DOI: 10.1007/s11356-023-31346-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Limited data have examined the association between air pollution and the risk of end-stage renal disease (ESRD) in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). We aimed to investigate whether long-term exposure to air pollutants is related to the development of ESRD among patients with T2DM and CKD. A total of 1,738 patients with T2DM and CKD hospitalized in Peking University Third Hospital from January 1, 2013, to December 31, 2021 were enrolled in this study. The outcome was defined as the occurrence of ESRD. Data on six air pollutants (PM2.5, PM10, CO, NO2, SO2, and O3) from 35 monitoring stations were obtained from the Beijing Municipal Ecological and Environmental Monitoring Center. Long-term exposure to air pollutants during the follow-up period was measured using the ordinary Kriging method. During a mean follow-up of 41 months, 98 patients developed ESRD. Multivariate logistic regression analysis showed that an increase of 10 μg/m3 in PM2.5 (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.03-1.36) and PM10 (OR 1.15, 95% CI 1.02-1.30) concentration were positively associated with ESRD. An increase of 1 mg/m3 in CO (2.80, 1.05-7.48) and an increase of 1 μg/m3 in SO2 (1.06, 1.00-1.13) concentration were also positively associated with ESRD. Apart from O3 and NO2, all the above air pollutants have additional predictive value for ESRD in patients with T2DM and CKD. The results of Bayesian kernel machine regression and the weighted quantile sum regression all showed that PM2.5 was the most important air pollutant. Backward stepwise logistic regression showed that PM2.5 was the only pollutant remaining in the prediction model. In patients with T2DM and CKD, long-term exposure to ambient PM2.5, PM10, CO, and SO2 was positively associated with the development of ESRD.
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Affiliation(s)
- Zhi Shang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, 100191, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
- NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Peking University, Beijing, China
- Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Yue-Ming Gao
- Department of Nephrology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China
| | - Zhen-Ling Deng
- Department of Nephrology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China
| | - Yue Wang
- Department of Nephrology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China.
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13
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Peng S, Chen B, Li Z, Sun J, Liu F, Yin X, Zhou Y, Shen H, Xiang H. Ambient ozone pollution impairs glucose homeostasis and contributes to renal function decline: Population-based evidence. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115803. [PMID: 38091674 PMCID: PMC10790241 DOI: 10.1016/j.ecoenv.2023.115803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
Particulate matter pollution could increase the risk of kidney disease, while evidence for ozone exposure is less well-established. Here, we aimed to evaluate the effect of ozone pollution on renal function and explore mechanisms. We first conducted a cross-sectional study based on Wuhan Chronic Disease Cohort Study baseline information. We recruited 2699 eligible participants, estimated their residential ozone concentrations, collected fasting peripheral blood samples for biochemical analysis and calculated the estimated glomerular filtration rate (eGFR). The linear regression model was applied to evaluate the long-term association between ozone pollution and eGFR. Then, we recruited another 70 volunteers as a panel with 8 rounds follow-up visits. We calculated the eGFR and measured fasting blood glucose and lipid levels. The linear mixed-effect model along with mediation analysis were performed to confirm the short-term association and explore potential mechanisms, respectively. For the long-term association, a 10.95 μg/m3 increment of 3-year ozone exposure was associated with 2.96 mL/min/1.73 m2 decrease in eGFR (95%CI: -4.85, -1.06). Furthermore, the drinkers exhibited a pronounced declination of eGFR (-7.46 mL/min/1.73 m2, 95%CI: -11.84, -3.08) compared to non-drinkers in relation to ozone exposure. Additionally, a 19.02 μg/m3 increase in 3-day ozone concentrations was related to 2.51 mL/min/1.73 m2 decrease in eGFR (95%CI: -3.78, -1.26). Hyperglycemia and insulin resistance mediated 12.2% and 16.5% of the aforementioned association, respectively. Our findings indicated that higher ozone pollution could affect renal function, and the hyperglycemia and insulin resistance linked to ozone might be the underlying mechanisms.
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Affiliation(s)
- Shouxin Peng
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China; Global Health Institute, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Bingbing Chen
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Zhaoyuan Li
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China; Global Health Institute, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Jinhui Sun
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China; Global Health Institute, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Feifei Liu
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China; Global Health Institute, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Xiaoyi Yin
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Yi Zhou
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China
| | - Huanfeng Shen
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430079, Hubei, PR China.
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, Hubei, PR China; Global Health Institute, Wuhan University, Wuhan 430071, Hubei, PR China.
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14
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Gan X, Zhang Y, He P, Ye Z, Zhou C, Liu M, Yang S, Zhang Y, Qin X. Positive association between ambient air pollutants and incident kidney stones. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:124067-124077. [PMID: 37996579 DOI: 10.1007/s11356-023-31136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
We aimed to assess the association between exposure to various air pollutants, individually or jointly, and incident kidney stones, and examine whether genetic susceptibility for kidney stones may modify this association. 453,977 participants without prior kidney stones from the UK Biobank were included. Annual mean concentrations of PM2.5, PM2.5-10, PM10, NO2, and NOx were estimated with a land use regression model. A weighted air pollution score was constructed that incorporates the five pollutants mentioned above. A genetic risk score (GRS) was calculated based on 20 single-nucleotide polymorphisms associated with kidney stones. The primary outcome was incident kidney stones. During a median follow-up of 11.9 years, 5,375 kidney stones were recorded. The adjusted HRs (95%CI) of incident kidney stones were 1.04 (1.01-1.07), 1.02 (1.00-1.05), 1.03 (1.01-1.06), 1.05 (1.02-1.08), and 1.04 (1.01-1.07), for per standard deviation (SD) increment in PM2.5 (SD:1.06 μg/m3), PM2.5-10 (SD:0.90 μg/m3), PM10 (SD:1.90 μg/m3), NO2 (SD:7.63 μg/m3), and NOx (SD: 15.63 μg/m3), respectively. Moreover, there was a significantly linear association between the air pollution score and incident kidney stones (per SD increment: HR, 1.05, 95%CI: 1.02-1.08), especially in those without diabetes (vs. participants with diabetes; P-interaction = 0.037). In addition, the association between air pollution and kidney stones was statistically significant only in participants within intermediate-high kidney stone GRS, but not in those with low GRS kidney stone, though the interaction was not significant (P-interaction = 0.385). In conclusion, exposure to air pollution was associated with a higher risk of incident kidney stones, calling for the need to improve air quality.
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Affiliation(s)
- Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
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15
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Mallah MA, Soomro T, Ali M, Noreen S, Khatoon N, Kafle A, Feng F, Wang W, Naveed M, Zhang Q. Cigarette smoking and air pollution exposure and their effects on cardiovascular diseases. Front Public Health 2023; 11:967047. [PMID: 38045957 PMCID: PMC10691265 DOI: 10.3389/fpubh.2023.967047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/26/2023] [Indexed: 12/05/2023] Open
Abstract
Cardiovascular disease (CVD) has no socioeconomic, topographical, or sex limitations as reported by the World Health Organization (WHO). The significant drivers of CVD are cardio-metabolic, behavioral, environmental, and social risk factors. However, some significant risk factors for CVD (e.g., a pitiable diet, tobacco smoking, and a lack of physical activities), have also been linked to an elevated risk of cardiovascular disease. Lifestyles and environmental factors are known key variables in cardiovascular disease. The familiarity with smoke goes along with the contact with the environment: air pollution is considered a source of toxins that contribute to the CVD burden. The incidence of myocardial infarction increases in males and females and may lead to fatal coronary artery disease, as confirmed by epidemiological studies. Lipid modification, inflammation, and vasomotor dysfunction are integral components of atherosclerosis development and advancement. These aspects are essential for the identification of atherosclerosis in clinical investigations. This article aims to show the findings on the influence of CVD on the health of individuals and human populations, as well as possible pathology and their involvement in smoking-related cardiovascular diseases. This review also explains lifestyle and environmental factors that are known to contribute to CVD, with indications suggesting an affiliation between cigarette smoking, air pollution, and CVD.
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Affiliation(s)
| | - Tahmina Soomro
- Department of Sociology, Shah Abdul Latif University, Khairpur, Pakistan
| | - Mukhtiar Ali
- Department of Chemical Engineering, Quaid-e-Awam University of Engineering, Science and Technology, Nawabshah, Sindh, Pakistan
| | - Sobia Noreen
- Department of Pharmaceutics Technology, Institute of Pharmacy, University of Innsbruck, Insbruck, Austria
| | - Nafeesa Khatoon
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Akriti Kafle
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Feifei Feng
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Muhammad Naveed
- Department of Physiology and Pharmacology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
| | - Qiao Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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16
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Fu Q, Li S, Xu L, Gao N, Wu W, Xu Q, Huang Y, Huang X, Huang Y. Subchronic exposure to PM 2.5 induced renal function damage and intestinal microflora changes in rats. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 267:115666. [PMID: 37944465 DOI: 10.1016/j.ecoenv.2023.115666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Exposure to inhalable environmental particulate matter with a diameter of 2.5 µm or smaller (PM2.5) is associated with decreased or impaired kidney function, but the underlying biological mechanisms are not fully understood. Gut microbiota is an emerging key player in the homeostasis regulation of the gut-kidney axis. Few studies have investigated its role in PM2.5 exposure-induced gut-kidney axis homeostasis abnormalities. METHODS In this study, a versatile aerosol concentration enrichment system for medium- to long-term whole-body exposure was used to expose Sprague-Dawley rats to filtered air (FA) or concentrated ambient PM2.5 for 12 weeks. A correlation analysis of renal impairment and the intestinal microbiome was performed. RESULTS The urine flow rate calculation and renal function analysis showed that PM2.5 exposure significantly impaired renal function and increased the urine flow rate. The fecal microbiota analysis showed that renal impairment and increased urine flow rates were consistent with the reduced estimates of the fecal bacteria Chao1, observed-species, Shannon, and Simpson (richness and diversity indices). Pearson's correlation analysis showed that the estimated bacterial richness and diversity were correlated with the urine flow rate and renal function. The linear discriminant analysis effect size (LEfSe) analysis revealed differences between animals exposed to PM2.5 and FA in 25 bacterial groups. Further correlation of a single bacterial taxon with the urine flow rate and renal function showed that the relative abundances of 30, 29, 21, and 50 distinct bacterial groups were significantly correlated with the urine flow rate, estimated glomerular filtration rate (eGFR), serum cystatin C (CysC), and beta-2 microglobulin (β2-MG), respectively. CONCLUSION Subchronic exposure to PM2.5 can cause intestinal ecological disorders, which may, in turn, lead to decreased kidney function or the development of impaired kidney function.
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Affiliation(s)
- Qiang Fu
- Affiliated Hospital of Jinggangshan University, Ji'an 343000, China; Center for Clinical Medicine Research, Health Science Center, Jinggangshan University, Ji'an 343009, China
| | - Sen Li
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, China
| | - Lu Xu
- Center for Clinical Medicine Research, Health Science Center, Jinggangshan University, Ji'an 343009, China
| | - Na Gao
- Center for Clinical Medicine Research, Health Science Center, Jinggangshan University, Ji'an 343009, China
| | - Weiqi Wu
- Center for Clinical Medicine Research, Health Science Center, Jinggangshan University, Ji'an 343009, China
| | - Qintao Xu
- Center for Clinical Medicine Research, Health Science Center, Jinggangshan University, Ji'an 343009, China
| | - Yuping Huang
- Department of Biochemistry and Molecular Biology, Gannan Medical University, Ganzhou 341000, China
| | - Xiaoliu Huang
- Affiliated Hospital of Jinggangshan University, Ji'an 343000, China; Center for Clinical Medicine Research, Health Science Center, Jinggangshan University, Ji'an 343009, China; Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, China.
| | - Yushan Huang
- Center for Evidence Based Medical and Clinical Research, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China.
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17
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Moon HW, Shin D, Cho HJ, Ha US, Hong SH, Lee JY, Kim SW, Park YH. Impact of Particulate Matter With an Aerodynamic Diameter <2.5 μm Concentration on Postoperative Renal Function in Living Kidney Donors. Transplant Proc 2023; 55:1515-1520. [PMID: 37385840 DOI: 10.1016/j.transproceed.2023.03.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/21/2023] [Accepted: 03/15/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Ambient air pollution has become 1 of the most important public health issues worldwide. In particular, particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) is a fatal component of air pollution. We aimed to analyze whether perioperative exposure to PM2.5 is associated with the deterioration of renal function in living kidney donors. METHODS This study was conducted on 232 kidney donors with postoperative 2-year glomerular filtration rate (GFR). The GFR was determined by serum creatinine-based method using the Modification of Diet in Renal Disease equation and radionuclide-based method using 99mTc-DTPA renal scintigraphy. Perioperative exposure to PM2.5 was calculated using data from the AIRKOREA System. Multiple linear and logistic regression analyses were performed to estimate the associations between mean PM2.5 concentration and postoperative 2-year GFR. RESULTS Postoperative Modification of Diet in Renal Disease-estimated GFRs of kidney donors with low PM2.5 concentrations were significantly higher than those of those with high PM2.5 concentrations. A 1-μg/m3 increase in mean PM2.5 concentration was associated with decreased GFR by 0.20 mL/min/1.73 m2. In addition, a 1-μg/m3 increase in mean PM2.5 concentration was associated with an 11% increased risk of chronic kidney disease stage ≥3 at 2 years after donor nephrectomy. CONCLUSION In patients who underwent donor nephrectomy, exposure to PM2.5 negatively affects renal function and is positively associated with the prevalence of chronic kidney disease.
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Affiliation(s)
- Hyong Woo Moon
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dongho Shin
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - U-Syn Ha
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong Hyun Park
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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18
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Rasking L, Koshy P, Bongaerts E, Bové H, Ameloot M, Plusquin M, De Vusser K, Nawrot TS. Ambient black carbon reaches the kidneys. ENVIRONMENT INTERNATIONAL 2023; 177:107997. [PMID: 37269720 DOI: 10.1016/j.envint.2023.107997] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Ultrafine particles, including black carbon (BC), can reach the systemic circulation and therefore may distribute to distant organs upon inhalation. The kidneys may be particularly vulnerable to the adverse effects of BC exposure due to their filtration function. OBJECTIVES We hypothesized that BC particles reach the kidneys via the systemic circulation, where the particles may reside in structural components of kidney tissue and impair kidney function. METHODS In kidney biopsies from 25 transplant patients, we visualized BC particles using white light generation under femtosecond-pulsed illumination. The presence of urinary kidney injury molecule-1 (KIM-1) and cystatin c (CysC) were evaluated with ELISA. We assessed the association between internal and external exposure matrices and urinary biomarkers using Pearson correlation and linear regression models. RESULTS BC particles could be identified in all biopsy samples with a geometric mean (5th, 95th percentile) of 1.80 × 103 (3.65 × 102, 7.50 × 103) particles/mm3 kidney tissue, predominantly observed in the interstitium (100 %) and tubules (80 %), followed by the blood vessels and capillaries (40 %), and the glomerulus (24 %). Independent from covariates and potential confounders, we found that each 10 % higher tissue BC load resulted in 8.24 % (p = 0.03) higher urinary KIM-1. In addition, residential proximity to a major road was inversely associated with urinary CysC (+10 % distance: -4.68 %; p = 0.01) and KIM-1 (+10 % distance: -3.99 %; p < 0.01). Other urinary biomarkers, e.g., the estimated glomerular filtration rate or creatinine clearance showed no significant associations. DISCUSSION AND CONCLUSION Our findings that BC particles accumulate near different structural components of the kidney represent a potential mechanism explaining the detrimental effects of particle air pollution exposure on kidney function. Furthermore, urinary KIM-1 and CysC show potential as air pollution-induced kidney injury biomarkers for taking a first step in addressing the adverse effects BC might exert on kidney function.
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Affiliation(s)
- Leen Rasking
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Priyanka Koshy
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Eva Bongaerts
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Hannelore Bové
- Department of Sciences, Hasselt University, Diepenbeek, Belgium
| | - Marcel Ameloot
- Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Katrien De Vusser
- Nephrology and Kidney Transplantation, University Hospital Leuven, Leuven, Belgium; Department of Microbiology and Immunology, Leuven University, Leuven, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Department of Public Health and Primary Care, Environment and Health Unit, Leuven University, Leuven, Belgium.
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19
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Garcia A, Santa-Helena E, De Falco A, de Paula Ribeiro J, Gioda A, Gioda CR. Toxicological Effects of Fine Particulate Matter (PM 2.5): Health Risks and Associated Systemic Injuries-Systematic Review. WATER, AIR, AND SOIL POLLUTION 2023; 234:346. [PMID: 37250231 PMCID: PMC10208206 DOI: 10.1007/s11270-023-06278-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/29/2023] [Indexed: 05/31/2023]
Abstract
Previous studies focused on investigating particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) have shown the risk of disease development, and association with increased morbidity and mortality rates. The current review investigate epidemiological and experimental findings from 2016 to 2021, which enabled the systemic overview of PM2.5's toxic impacts on human health. The Web of Science database search used descriptive terms to investigate the interaction among PM2.5 exposure, systemic effects, and COVID-19 disease. Analyzed studies have indicated that cardiovascular and respiratory systems have been extensively investigated and indicated as the main air pollution targets. Nevertheless, PM2.5 reaches other organic systems and harms the renal, neurological, gastrointestinal, and reproductive systems. Pathologies onset and/or get worse due to toxicological effects associated with the exposure to this particle type, since it can trigger several reactions, such as inflammatory responses, oxidative stress generation and genotoxicity. These cellular dysfunctions lead to organ malfunctions, as shown in the current review. In addition, the correlation between COVID-19/Sars-CoV-2 and PM2.5 exposure was also assessed to help better understand the role of atmospheric pollution in the pathophysiology of this disease. Despite the significant number of studies about PM2.5's effects on organic functions, available in the literature, there are still gaps in knowledge about how this particulate matter can hinder human health. The current review aimed to approach the main findings about the effect of PM2.5 exposure on different systems, and demonstrate the likely interaction of COVID-19/Sars-CoV-2 and PM2.5.
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Affiliation(s)
- Amanda Garcia
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
| | - Eduarda Santa-Helena
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Departmento de Química, Rio de Janeiro, Brazil
| | - Anna De Falco
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Departmento de Química, Rio de Janeiro, Brazil
| | - Joaquim de Paula Ribeiro
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
| | - Adriana Gioda
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Departmento de Química, Rio de Janeiro, Brazil
| | - Carolina Rosa Gioda
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
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20
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Wen F, Xie Y, Li B, Li P, Qi H, Zhang F, Sun Y, Zhang L. Combined effects of ambient air pollution and PM 2.5 components on renal function and the potential mediation effects of metabolic risk factors in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:115039. [PMID: 37235899 DOI: 10.1016/j.ecoenv.2023.115039] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Growing evidence links long-term air pollution exposure with renal function. However, little research has been conducted on the combined effects of air pollutant mixture on renal function and multiple mediation effects of metabolic risk factors. This study enrolled 8996 adults without chronic kidney disease (CKD) at baseline from the CHCN-BTH cohort study. Three-year exposure to air pollutants [particulate matter ≤ 2.5 µm (PM2.5), PM10, PM1, ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO)] and PM2.5 components [black carbon (BC), ammonium (NH4+), nitrate (NO3-), sulfate (SO42-) and organic matter (OM)] were assessed using well-validated machine learning methods. Linear mixed models were applied to investigate the associations between air pollutants and estimated glomerular filtration rate (eGFR). Quantile G-computation was used to assess the combined effects of pollutant mixtures. Causal mediation analysis and Bayesian mediation analysis were employed to estimate the mediation effects of metabolic risk factors. An interquartile range increases in BC (-0.256, 95 %CI: -0.331, -0.180) and OM (-0.603, 95 %CI: -0.810, -0.397) were significantly associated with eGFR decline; while O3 (1.151, 95 %CI: 0.813, 1.489), PM10 (0.721, 95 %CI: 0.309, 1.133), NH4+ (0.990, 95 %CI: 0.638, 1.342), and NO3- (0.610, 95 %CI: 0.405, 0.815) were associated with higher eGFR. The combined effect of the PM2.5 component mixture was found to be associated with lower eGFR (-1.147, 95 % CI: -1.456, -0.839), with OM contributing 72.4 % of the negative effect. Univariate mediation analyses showed that high-density lipoprotein (HDL) mediated 7.1 %, 6.9 %, and 6.1 % effects of O3, BC, and OM, respectively. However, these mediation effects were not significant in Bayesian mediation analysis. These findings suggest the effect of the PM2.5 component mixture on eGFR decline and the strong contribution of OM. Metabolic risk factors may not mediate the effects of air pollutants. Further study is warranted to clarify the potential mechanisms involved.
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Affiliation(s)
- Fuyuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Pandi Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Han Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fengxu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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21
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Lee W, Wu X, Heo S, Kim JM, Fong KC, Son JY, Sabath MB, Trisovic A, Braun D, Park JY, Kim YC, Lee JP, Schwartz J, Kim H, Dominici F, Al-Aly Z, Bell ML. Air Pollution and Acute Kidney Injury in the U.S. Medicare Population: A Longitudinal Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47008. [PMID: 37036790 PMCID: PMC10084931 DOI: 10.1289/ehp10729] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Recent studies have reported the association between air pollution exposure and reduced kidney function. However, it is unclear whether air pollution is associated with an increased risk of acute kidney injury (AKI). OBJECTIVES To address this gap in knowledge, we investigated the effect estimates of long-term exposures to fine particulate matter [PM ≤ 2.5 μ m in aerodynamic diameter (PM 2.5 )], nitrogen dioxide (NO 2 ), and ozone (O 3 ) on the risk of first hospital admission for AKI using nationwide Medicare data. METHODS This nationwide population-based longitudinal cohort study included 61,300,754 beneficiaries enrolled in Medicare Part A fee-for-service (FFS) who were ≥ 65 years of age and resided in the continental United States from the years 2000 through 2016. We applied Cox-equivalent Poisson models to estimate the association between air pollution and first hospital admission for AKI. RESULTS Exposure to PM 2.5 , NO 2 , and O 3 was associated with increased risk for first hospital admission for AKI, with hazard ratios (HRs) of 1.17 (95% CI: 1.16, 1.19) for a 5 - μ g / m 3 increase in PM 2.5 , 1.12 (95% CI: 1.11, 1.13) for a 10 -ppb increase in NO 2 , and 1.03 (95% CI: 1.02, 1.04) for a 10 -ppb increase in summer-period O 3 (June to September). The associations persisted at annual exposures lower than the current National Ambient Air Quality Standard. DISCUSSION This study found an association between exposures to air pollution and the risk of the first hospital admission with AKI, and this association persisted even at low concentrations of air pollution. Our findings provide beneficial implications for public health policies and air pollution guidelines to alleviate health care expenditures and the disease burden attributable to AKI. https://doi.org/10.1289/EHP10729.
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Affiliation(s)
- Whanhee Lee
- School of Biomedical Convergence Engineering, Pusan National University, Yangsan, Republic of Korea
| | - Xiao Wu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Seulkee Heo
- Yale School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Joyce Mary Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Kelvin C. Fong
- Yale School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Ji-Young Son
- Yale School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Matthew Benjamin Sabath
- Faculty of Arts and Sciences Research Computing Department, Harvard University, Boston, Massachusetts, USA
| | - Ana Trisovic
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Danielle Braun
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Jae Yoon Park
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Republic of Korea
- Department of Internal Medicine, Dongguk University College of Medicine, Republic of Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Republic of Korea
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute for Sustainable Development, Graduate School of Public Health, Seoul National University, Republic of Korea
| | - Francesca Dominici
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Ziyad Al-Aly
- Nephrology Section, Medicine Service, Veterans Affairs Saint Louis Health Care System, Saint Louis, Missouri, USA
- Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
- Institute for Public Health, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Michelle L. Bell
- Yale School of the Environment, Yale University, New Haven, Connecticut, USA
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22
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Kim KN, Shin MK, Lim YH, Bae S, Kim JH, Hwang SS, Kim MJ, Oh J, Lim H, Choi J, Kwon HJ. Associations of cold exposure with hospital admission and mortality due to acute kidney injury: A nationwide time-series study in Korea. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160960. [PMID: 36528107 DOI: 10.1016/j.scitotenv.2022.160960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/28/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Emerging evidence supports an association between heat exposure and acute kidney injury (AKI). However, there is a paucity of studies on the association between cold exposure and AKI. OBJECTIVE We aimed to investigate the associations of cold exposure with hospital admission and mortality due to AKI and to explore whether these associations were influenced by age and sex. METHODS Information on daily counts of hospital admission and mortality due to AKI in 16 regions of Korea during the cold seasons (2010-2019) was obtained from the National Health Insurance Service (a single national insurer providing universal health coverage) and Statistics Korea. Daily mean temperature and relative humidity were calculated from hourly data obtained from 94 monitoring systems operated by the Korean Meteorological Administration. Associations of low temperatures (<10th percentile of daily mean temperature) and cold spells (≥2 consecutive days with <5th percentile of daily mean temperature) up to 21 days with AKI were estimated using quasi-Poisson regression models adjusted for potential confounders (e.g., relative humidity and air pollutants) with distributed lag models and univariate meta-regression models. RESULTS Low temperatures were associated with hospital admission due to AKI [relative risk (RR) = 1.12, 95 % confidence interval (CI): 1.09, 1.16]. Cold spells were associated with hospital admission (RR = 1.87, 95 % CI: 1.46, 2.39) and mortality due to AKI (RR = 4.84, 95 % CI: 1.30, 17.98). These associations were stronger among individuals aged ≥65 years than among those aged <65 years. CONCLUSION Our results underscore the need for the general population, particularly the elderly, physicians, and other healthcare providers to be more vigilant to cold exposure, given the risk of AKI. Government agencies need to develop specific strategies for the prevention and early detection of cold exposure-related AKI.
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Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Moon-Kyung Shin
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Seung-Sik Hwang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Mi-Ji Kim
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Jongmin Oh
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyungryul Lim
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jonghyuk Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
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Hu LK, Liu YH, Yang K, Chen N, Ma LL, Yan YX. Associations between long-term exposure to ambient fine particulate pollution with the decline of kidney function and hyperuricemia: a longitudinal cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:40507-40518. [PMID: 36609761 DOI: 10.1007/s11356-023-25132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
Evidence of associations between ambient fine particulate matter (PM2.5) and risks of decline of kidney function and hyperuricemia is limited. We aimed to investigate the associations between long-term exposure to PM2.5 with decline of kidney function and hyperuricemia in China. We conducted a two-stage study based on China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. Cox proportional hazard regression models and restricted cubic splines were used to evaluate the associations of PM2.5 with risks of decline of kidney function and hyperuricemia. Latent class trajectory models (LCTM) were used to identify trajectories of PM2.5 from 2011 to 2015 in the sensitivity analysis. A total of 9760 participants were included in baseline analysis, and 5902 participants were in follow-up analysis. PM2.5 was associated with the risks of decline of kidney function [hazard ratio (HR): 2.14; 95% confidence interval (CI): (1.03, 4.44)] and hyperuricemia [HR 1.40 (95% CI: 1.10, 1.79)] in the second quartile group versus the lowest quartile group of PM2.5. We also observed nonlinear relationships between PM2.5 and the risks of the decline of kidney function and hyperuricemia (Pnon-linear < 0.001). In sensitivity analysis, four trajectory groups were identified. "Maintaining a high PM2.5" [odds ratio (OR): 2.20; 95%CI: (1.78, 2.73)] and "moderately high starting PM2.5 then steadily decreased" [OR (95%CI): 5.15 (1.55, 16.13)] were associated with hyperuricemia risk, using "low starting PM2.5 then steadily decreased" trajectory as reference. In conclusion, improved air quality is essential for prevention of decline of kidney function and hyperuricemia.
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Affiliation(s)
- Li-Kun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Yu-Hong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Kun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Lin-Lin Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China.
- Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
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24
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Chen SF, Chien YH, Chen PC. The association between long-term ambient fine particulate exposure and the mortality among adult patients initiating dialysis: A retrospective population-based cohort study in Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120606. [PMID: 36368554 DOI: 10.1016/j.envpol.2022.120606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Fine particulate matter (PM2.5) has been reported to be associated with increased risk of chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, studies on whether long-term exposure to PM2.5 negatively impacts the survival of patients with ESRD are very limited. To conduct this study, we linked Taiwan Air Quality-Monitoring Database (TAQMD) and the National Health Insurance Research Database (NHIRD) by zip-code. A retrospective population-based cohort of 34,088 adult patients initiating dialysis over six months was formed. Cox proportional regression models were used to estimate the risk of mortality in dialysis patients per 10-μg/m3 increase of PM2.5 and by PM2.5 levels divided into quintiles. Restricted cubic spline analysis was performed to delineate the concentration-response relationship between PM2.5 and mortality. The adjusted hazard ratio (aHR) per 10-μg/m3 increase of PM2.5 for mortality was 1.11 (95% confidence interval [CI] = 1.08-1.13). When analyzing PM2.5 exposure divided into quintiles, patients with mean PM2.5 exposure over 29.33 μg/m3, including level III (aHR 1.00, 95% CI = 0.94-1.07), level IV (aHR 1.09; 95% CI = 1.03-1.16), and level V (HR 1.11; 95% CI = 1.05-1.19), were at stepwise higher risks of mortality compared with level I. Spline analysis showed a non-linear concentration-response function between PM2.5 and mortality, with the lowest mortality aHR identified at a mean PM2.5 of 26 μg/m3, followed by a concentration interval with a gradual increase of aHR, and finally a steep rise of mortality risk when mean PM2.5 exceeded 37 μg/m3. Individuals with older age, those were male, with selected comorbidities, and with low socioeconomic status (SES) were at higher mortality risk. Male and non-diabetics participants were more sensitive to the effect of a 10-μg/m3 of PM2.5 increase on mortality than their counterparts. In conclusion, long-term exposure to PM2.5 exceeding a threshold was observed to be associated with increased risk of mortality among dialysis patients.
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Affiliation(s)
- Shih-Feng Chen
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yu-Hui Chien
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan.
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Chang PY, Li YL, Chuang TW, Chen SY, Lin LY, Lin YF, Chiou HY. Exposure to ambient air pollutants with kidney function decline in chronic kidney disease patients. ENVIRONMENTAL RESEARCH 2022; 215:114289. [PMID: 36116493 DOI: 10.1016/j.envres.2022.114289] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/18/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
Chronic kidney disease (CKD) has been a global public health problem with many adverse outcomes, but data are lacking regarding the relationship between air pollutants and risk of renal progression in patients with CKD. This study was to investigate whether 1-year average exposure to ambient air pollutants -CO, NO, NO2, SO2, O3, PM2.5, and PM10-is related to renal function deterioration among patients with CKD. A total of 5301 CKD patients were included in this study between October 2008 and February 2016. To estimate each patient's exposure to ambient air pollution, we used the 24-h ambient air pollution concentration monitoring data collected one year prior to renal progression or their last renal function assessment. Renal progression was considered when estimated glomerular filtration rate (eGFR) decreased more than 25% from the baseline eGFR. Cox proportional hazard regression was performed to calculate hazard ratios (HRs). Among 5301 patients with CKD, 1813 (34.20%) developed renal progression during the 30.48 ± 14.99-month follow-up. Patients with the highest quartile exposure to CO [HR = 1.53 (95% CI: 1.24, 1.88)], NO [HR = 1.38 (95% CI: 1.11, 1.71)], NO2 [HR = 1.63 (95% CI: 1.36, 1.97)], SO2 [HR = 2.27 (95% CI: 1.83, 2.82)], PM2.5 [HR = 7.58 (95% CI: 5.97, 9.62)], and PM10 [HR = 3.68 (95% CI: 2.84, 4.78)] had a significantly higher risk of renal progression than those with the lowest quartile exposure. In the multipollutant model, the analyses yielded to similar results. These results reinforce the importance of measures to mitigate air pollution and strategies to prevent worsening of kidney function in patients with CKD. One-year high exposure to ambient CO, NO, NO2, SO2, PM2.5, and PM10 is significantly associated with deteriorated kidney function in patients with CKD among Taiwanese adults.
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Affiliation(s)
- Po-Ya Chang
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yu-Ling Li
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei, Taiwan
| | - Szu-Ying Chen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Li-Yin Lin
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yuh-Feng Lin
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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Luo C, Ouyang Y, Shi S, Li G, Zhao Z, Luo H, Xu F, Shao L, Chen Z, Yu S, Jin Y, Xu J, Du W, Fang Z, Jafar Hussain HM, Zhang W, Wang W, Cui Y, Zhang H, Chen N, Yu Z, Xie J. Particulate matter of air pollution may increase risk of kidney failure in IgA nephropathy. Kidney Int 2022; 102:1382-1391. [PMID: 36087808 DOI: 10.1016/j.kint.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/16/2022] [Accepted: 08/01/2022] [Indexed: 01/12/2023]
Abstract
IgA nephropathy (IgAN) is characterized by deposition of galactose-deficient IgA1 (Gd-IgA1) in glomerular mesangium associated with mucosal immune disorders. Since environmental pollution has been associated with the progression of chronic kidney disease in the general population, we specifically investigated the influence of exposure to fine particulate matter less than 2.5 μm in diameter (PM2.5) on IgAN progression. Patients with biopsy-proven primary IgAN were recruited from seven Chinese kidney centers. PM2.5 exposure from 1998 to 2016 was derived from satellite aerosol optical depth data and a total of 1,979 patients with IgAN, including 994 males were enrolled. The PM2.5 exposure levels for patients from different provinces varied but, in general, the PM2.5 exposure levels among patients from the north were higher than those among patients from the south. The severity of PM2.5 exposure in different regions was correlated with regional kidney failure burden. In addition, each 10 μg/m3 increase in annual average concentration of PM2.5 exposure before study entry (Hazard Ratio, 1.14; 95% confidence interval, 1.06-1.22) or time-varying PM2.5 exposure after study entry (1.10; 1.01-1.18) were associated with increased kidney failure risk after adjustment for age, gender, estimated glomerular filtration rate, urine protein, uric acid, hemoglobin, mean arterial pressure, Oxford classification, glucocorticoid and renin-angiotensin system blocker therapy. The associations were robust when the time period, risk factors of cardiovascular diseases or city size were further adjusted on the basis of the above model. Thus, our results suggest that PM2.5 is an independent risk factor for kidney failure in patients with IgAN, but these findings will require validation in more diverse populations and other geographic regions.
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Affiliation(s)
- Chengwen Luo
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China; Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Zhejiang, China
| | - Yan Ouyang
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sufang Shi
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
| | - Guisen Li
- Department of Nephrology, Sichuan Provincial People's Hospital, Chengdu, China
| | - Zhanzheng Zhao
- Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huimin Luo
- Department of Nephrology, the First People's Hospital of Yunnan Province, Kunming, China
| | - Feifei Xu
- Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Leping Shao
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Zijin Chen
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuwen Yu
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanmeng Jin
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Xu
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Du
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengying Fang
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hafiz Muhammad Jafar Hussain
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiming Wang
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yidan Cui
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
| | - Nan Chen
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhangsheng Yu
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China; Shanghai Jiaotong University School of Medicine Clinical Research Center, Shanghai, China.
| | - Jingyuan Xie
- Department of Nephrology, Institute of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Guo C, Chang LY, Wei X, Lin C, Zeng Y, Yu Z, Tam T, Lau AKH, Huang B, Lao XQ. Multi-pollutant air pollution and renal health in Asian children and adolescents: An 18-year longitudinal study. ENVIRONMENTAL RESEARCH 2022; 214:114144. [PMID: 35998701 DOI: 10.1016/j.envres.2022.114144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Few studies have examined the effects of multi-pollutant air pollution on renal health, especially in children and adolescents. This study investigated the association between long-term ambient air pollution exposure and renal health in Asian children and adolescents. METHODS This study included 10,942 children and adolescents from Taiwan and Hong Kong between 2000 and 2017. PM2.5, NO2 and O3 concentrations were estimated using satellite-based spatiotemporal regression models. Two-year average concentrations, those of the year of visit and the preceding year, were used. Linear mixed models were used to examine the association between air pollution and yearly changes in estimated glomerular filtration rate (eGFR). Cox regression models with time-dependent covariates were used to examine the association between air pollution and the development of chronic kidney disease (CKD). RESULTS Median age of the participants was 19 years (range: 2-25). The overall average concentration of PM2.5, NO2 and O3 was 26.7 μg/m3, 44.1 μg/m3 and 51.1 μg/m3, respectively. The mean yearly change in eGFR was 0.37 μL/min/1.73 m2 and the incidence rate of CKD was 6.8 per 1,000 person-years. In single-pollutant models, each 10 μg/m3 increase in PM2.5 was associated with a 0.45 μL/min/1.73 m2 [95% confidence interval (CI): 0.28-0.63] reduction in the yearly increase in eGFR and 53% [hazard ratio (HR): 1.53 (95%CI: 1.07-2.2)] greater risk of incident CKD. Each 10 μg/m3 increase in NO2 was associated with a 7% [HR (95%CI): 1.07 (1.00-1.15)] higher risk of incident CKD, while an equivalent increase in O3 was associated with a 19% [HR (95%CI): 0.81 (0.67-0.98)] lower risk. CONCLUSIONS Long-term exposure to ambient PM2.5 and NO2 was associated with a slower growth of eGFR and a higher risk of incident CKD in children and adolescents. Our findings suggest that air pollution control in early life is imperative to improve lifelong renal health and alleviate the CKD burden.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Xianglin Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Henan, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Bo Huang
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
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Duan JW, Li YL, Li SX, Yang YP, Li F, Li Y, Wang J, Deng PZ, Wu JJ, Wang W, Meng CJ, Miao RJ, Chen ZH, Zou B, Yuan H, Cai JJ, Lu Y. Association of Long-term Ambient Fine Particulate Matter (PM 2.5) and Incident CKD: A Prospective Cohort Study in China. Am J Kidney Dis 2022; 80:638-647.e1. [PMID: 35469967 DOI: 10.1053/j.ajkd.2022.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/05/2022] [Indexed: 02/02/2023]
Abstract
RATIONALE & OBJECTIVE Increasing evidence has linked ambient fine particulate matter (ie, particulate matter no larger than 2.5 μm [PM2.5]) to chronic kidney disease (CKD), but their association has not been fully elucidated, especially in regions with high levels of PM2.5 pollution. This study aimed to investigate the long-term association of high PM2.5 exposure with incident CKD in mainland China. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS 72,425 participants (age ≥18 years) without CKD were recruited from 121 counties in Hunan Province, China. EXPOSURE Annual mean PM2.5 concentration at the residence of each participant derived from a long-term, full-coverage, high-resolution (1 × 1 km2), high-quality dataset of ground-level air pollutants in China. OUTCOMES Incident CKD during the interval between the baseline examination of each participant (2005-2017) and the end of follow-up through 2018. ANALYTICAL APPROACH Cox proportional hazards models were used to estimate the independent association of PM2.5 with incident CKD and the joint association of PM2.5 with temperature or humidity on the development of PM2.5-related CKD. Restricted cubic splines were used to model exposure-response relationships. RESULTS Over a median follow-up of 3.79 (IQR, 2.03-5.48) years, a total of 2,188 participants with incident CKD were identified. PM2.5 exposure was associated with incident CKD with an adjusted hazard ratio of 1.71 (95% CI, 1.58-1.85) per 10-μg/m3 greater long-term exposure. Multiplicative interactions between PM2.5 and humidity or temperature on incident CKD were detected (all P < 0.001 for interaction), whereas an additive interaction was detected only for humidity (relative risk due to interaction, 3.59 [95% CI, 0.97-6.21]). LIMITATIONS Lack of information on participants' activity patterns such as time spent outdoors. CONCLUSIONS Greater long-term ambient PM2.5 pollution is associated with incident CKD in environments with high PM2.5 exposure. Ambient humidity has a potentially synergetic effect on the association of PM2.5 with the development of CKD. PLAIN-LANGUAGE SUMMARY Exposure to a form of air pollution known as fine particulate matter (ie, particulate matter ≤2.5 μm [PM2.5]) has been linked to an increased risk of chronic kidney disease (CKD), but little is known about how PM2.5 affects CKD in regions with extremely high levels of PM2.5 pollution. This longitudinal cohort study in China investigates the effect of PM2.5 on the incidence of CKD and whether temperature or humidity interact with PM2.5. Our findings suggest that long-term exposure to high levels of ambient PM2.5 significantly increased the risk of CKD in mainland China, especially in terms of cumulative average PM2.5. The associations of PM2.5 and incident CKD were greater in high-humidity environments. These findings support the recommendation that reducing PM2.5 pollution should be a priority to decrease the burden of associated health risks, including CKD.
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Affiliation(s)
- Jing-Wen Duan
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ya-Lan Li
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shen-Xin Li
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Yi-Ping Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Fei Li
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yan Li
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Pei-Zhi Deng
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing-Jing Wu
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wei Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chang-Jiang Meng
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ru-Jia Miao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhi-Heng Chen
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Bin Zou
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Hong Yuan
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing-Jing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Yao Lu
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China; School of Life Course Sciences, King's College London, London, United Kingdom.
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马 麟, 吴 静, 李 双, 李 鹏, 张 路. [Effect of modification of antihypertensive medications on the association of nitrogen dioxide long-term exposure and chronic kidney disease]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:1047-1055. [PMID: 36241250 PMCID: PMC9568383 DOI: 10.19723/j.issn.1671-167x.2022.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To investigate the potential effect of modification of antihypertensive medications on the association of nitrogen dioxide (NO2) long-term exposure and chronic kidney disease (CKD). METHODS Data of the national representative sample of adult population from the China National Survey of Chronic Kidney Disease (2007-2010) were included in the analyses, and exposure data of NO2 were collected and matched. Generalized mixed-effects models were used to analyze the associations between NO2 and CKD, stratified by the presence of hypertension and taking antihypertensive medications. The stratified exposure-response curves of NO2 and CKD were fitted using the natural spine smoothing function. The modifying effects of antihypertensive medications on the association and the exposure-response curve of NO2 and CKD were analyzed. RESULTS Data of 45 136 participants were included, with an average age of (49.5±15.3) years. The annual average exposure concentration of NO2 was (7.2±6.4) μg/m3. Altogether 6 517 (14.4%) participants were taking antihypertensive medications, and 4 833 (10.7%) participants were identified as having CKD. After adjustment for potential confounders, in the hypertension population not using antihypertensive medications, long-term exposure to NO2 was associated with a significant increase risk of CKD (OR: 1.38, 95%CI: 1.24-1.54, P < 0.001); while in the hypertension population using antihypertensive medications, no significant association between long-term exposure to NO2 and CKD (OR: 0.96, 95%CI: 0.86-1.07, P=0.431) was observed. The exposure-response curve of NO2 and CKD suggested that there was a non-linear trend in the association between NO2 and CKD. The antihypertension medications showed significant modifying effects both on the association and the exposure-response curve of NO2 and CKD (interaction P < 0.001). CONCLUSION The association between long-term exposure to NO2 and CKD was modified by antihypertensive medications. Taking antihypertensive medications may mitigate the effect of long-term exposure to NO2 on CKD.
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Affiliation(s)
- 麟 马
- 北京大学医学部学科建设办公室, 北京 100191Office of Development Planning and Academic Development, Peking University, Beijing 100191, China
| | - 静依 吴
- 浙江省北大信息技术高等研究院, 杭州 311215Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - 双成 李
- 北京大学地表过程分析与模拟教育部重点实验室, 北京大学城市与环境学院, 北京 100871Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - 鹏飞 李
- 浙江省北大信息技术高等研究院, 杭州 311215Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
- 北京大学健康医疗大数据国家研究院, 北京 100191National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - 路霞 张
- 浙江省北大信息技术高等研究院, 杭州 311215Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
- 北京大学健康医疗大数据国家研究院, 北京 100191National Institute of Health Data Science, Peking University, Beijing 100191, China
- 北京大学第一医院肾内科, 北京大学肾脏病研究所, 北京 100034Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China
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30
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Oh J, Ye S, Kang DH, Ha E. Association between exposure to fine particulate matter and kidney function: Results from the Korea National Health and Nutrition Examination Survey. ENVIRONMENTAL RESEARCH 2022; 212:113080. [PMID: 35314162 DOI: 10.1016/j.envres.2022.113080] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The incidence and prevalence of chronic kidney disease (CKD) are increasing worldwide. Recent studies have shown that air pollution is associated with poorer kidney function. We evaluated the association of long-term exposure to air pollutants with kidney function, and with risk of CKD using data from the seventh Korean National Health and Nutrition Examination Survey (KNHANES). METHODS KNHANES data from 2016 through 2018 and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation were used to calculate estimated glomerular filtration rates (eGFRs) and define the CKD patients with eGFRs <60 mL/min/1.73 m2. After applying the sampling weights based on the complex survey design, we conducted multivariate linear regression and logistic regression analyses to examine the association of air pollutant exposure with kidney function and CKD risk, after adjusting for covariates, including gender, body mass index, education level, household income, smoking status, alcohol consumption, comorbidities, and serum triglyceride. RESULTS A total of 15,983 adults aged ≥20 years were included in the analysis. Long-term exposure to PM2.5, PM10, NO2, and CO was associated with decreases in eGFR levels (PM2.5: -4.67, 95% confidence interval (CI): -6.16, -3.18; PM10: -2.19, 95% CI: -2.84, -1.54; NO2: -1.56, 95% CI: -2.16, -0.97; CO: -1.34, 95% CI: -1.96, -0.71). Long-term exposure to PM2.5 (odds ratio (OR): 1.97, 95% CI: 1.14, 3.42) and PM10 (OR: 1.45, 95% CI: 1.10, 1.91) was associated with an increased the risk of CKD. CONCLUSIONS Annual exposure to PM2.5, PM10, NO2, and CO was significantly associated with decreased eGFR. Long-term exposure to PM2.5 and PM10 was associated with an increased risk of CKD.
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Affiliation(s)
- Jongmin Oh
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Shinhee Ye
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Republic of Korea
| | - Duk-Hee Kang
- Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine Ewha Medical Research Center, Seoul, South Korea.
| | - Eunhee Ha
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, Ewha Womans University, Ewha Medical Research Institute, College of Medicine, Seoul, Republic of Korea.
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Ahn J, Bae S, Chung BH, Myong JP, Park MY, Lim YH, Kang MY. Association of summer temperatures and acute kidney injury in South Korea: a case-crossover study. Int J Epidemiol 2022:6661204. [PMID: 35950799 DOI: 10.1093/ije/dyac163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Due to climate change, days with high temperatures are becoming more frequent. Although the effect of high temperature on the kidneys has been reported in research from Central and South America, Oceania, North America and Europe, evidence from Asia is still lacking. This study aimed to examine the association between short-term exposure to high temperatures and acute kidney injury (AKI) in a nationwide study in South Korea. METHODS We used representative sampling data from the 2002-2015 National Health Insurance Service-National Sample Cohort in South Korea to link the daily mean temperatures and AKI cases that occurred in the summer. We used a bidirectional case-crossover study design with 0-7 lag days before the emergency room visit for AKI. In addition, we stratified the data into six income levels to identify the susceptible population. RESULTS A total of 1706 participants were included in this study. The odds ratio (OR) per 1°C increase at 0 lag days was 1.051, and the ORs per 1°C increase at a lag of 2 days were both 1.076. The association between exposure to high temperatures and AKI was slightly greater in the low-income group (OR = 1.088; 95% CI: 1.049-1.128) than in the high-income group (OR = 1.065; 95% CI: 1.026-1.105). CONCLUSIONS In our study, a relationship between exposure to high temperatures and AKI was observed. Precautions should be taken at elevated temperatures to minimize the risk of negative health effects.
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Affiliation(s)
- Joonho Ahn
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Ha Chung
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Min Young Park
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
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Wu CY, Hsu CT, Chung MC, Chen CH, Wu MJ. Air Pollution Alleviation During COVID-19 Pandemic is Associated with Renal Function Decline in Stage 5 CKD Patients. J Multidiscip Healthc 2022; 15:1901-1908. [PMID: 36072276 PMCID: PMC9442911 DOI: 10.2147/jmdh.s371815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Methods Results Conclusion
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Affiliation(s)
- Chun-Yi Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Chia-Tien Hsu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Department of Life Science, Tunghai University, Taichung, Taiwan
| | - Ming-Ju Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medical Sciences, School of Medicine, China Medical University, Taichung, Taiwan
- RongHsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Correspondence: Ming-Ju Wu, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun Dist, Taichung City, 407219, Taiwan, Email
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Xie G, Wang R, Yang W, Sun L, Xu M, Zhang B, Yang L, Shang L, Qi C, Chung MC. Associations among prenatal PM 2.5, birth weight, and renal function. CHEMOSPHERE 2022; 301:134668. [PMID: 35460673 DOI: 10.1016/j.chemosphere.2022.134668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 04/02/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Low birth weight has long-term health effects, including neurodevelopmental delays, cardiovascular diseases, and type 2 diabetes, through epigenetic changes and modifications. Numerous studies have identified that PM2.5 is associated with low birth weight. However, the association between PM2.5 and renal function, as well as the mediated effect of renal function on the association between prenatal PM2.5 and birth weight are still under-recognized. METHODS A total of 8969 singleton live births born in 2015-2019 were included in this study. The inverse distance weighting method was applied to interpolate and calculate the average exposure to PM2.5 during pregnancy for each pregnant woman. The multiple linear regression model was used to shed light on the associations among prenatal PM2.5, birth weight, and renal function. In addition, the mediation analysis was performed to figure out the mediated effect of renal function on the association between prenatal PM2.5 and birth weight, and the proportion of mediated effect = (indirect effect/total effect) × 100%. RESULTS Per 10 μg/m3 increment of prenatal PM2.5 was associated with 8.98 g (95% CI: -16.94 to -1.02) decrease of birth weight, 0.49 (95% CI: -0.73 to -0.26) ml/min/1.73 m2 decrease of glomerular filtration rate (GFR), 0.03 (95% CI: 0.01-0.05) mmol/L increase of blood urea nitrogen (BUN), and 2.29 (95% CI: 0.86-3.72) μmol/L increase of uric acid (UA) after adjusting for the sociodemographic covariates, disease-related covariates and meteorological factors. Besides, the mediated effects of GFR and BUN on the association between prenatal PM2.5 and birth weight were 5.02% and 14.96%, but there was no significant mediated effect being identified in UA. CONCLUSION Prenatal PM2.5 is related to reduced birth weight and impaired renal function. Renal function plays a partial role in the association between prenatal PM2.5 and birth weight. Appropriate guidelines should be formulated by the concerned authorities, and adequate efforts should be made to mitigate the detrimental health effects of PM2.5.
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Affiliation(s)
- Guilan Xie
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China
| | - Ruiqi Wang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China.
| | - Landi Sun
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China
| | - Mengmeng Xu
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China
| | - Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China
| | - Cuifang Qi
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Mei Chun Chung
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Massachusetts Boston, USA
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Kang E, Yim HE, Nam YJ, Jeong SH, Kim JA, Lee JH, Son MH, Yoo KH. Exposure to airborne particulate matter induces renal tubular cell injury in vitro: the role of vitamin D signaling and renin-angiotensin system. Heliyon 2022; 8:e10184. [PMID: 36033312 PMCID: PMC9403349 DOI: 10.1016/j.heliyon.2022.e10184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/16/2022] [Accepted: 08/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background Exposure to air pollution can interfere with the vitamin D endocrine system. This study investigated the effects of airborne particulate matter (PM) on renal tubular cell injury in vitro and explored the underlying mechanisms. Methods HK-2 human renal proximal tubule cells were treated with PM with or without 1,25(OH)2D3 analog, 19-Nor-1,25(OH)2D2 (paricalcitol, 10 nM) for 48 h. The dose- and time-dependent cytotoxicity of PM with or without paricalcitol was determined via cell counting kit-8 assay. Cellular oxidative stress was assessed using commercially available enzyme-linked immunosorbent assay kits. The protein expression of vitamin D receptor (VDR), cytochrome P450(CYP)27B1, CYP24A1, renin, angiotensin converting enzyme (ACE), angiotensin II type 1 receptor (AT1), nuclear factor erythroid 2-related factor 2 (Nrf2), nuclear factor-kB (NF-kB), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 was determined. Results PM exposure decreased HK-2 cell viability in a dose- and time-dependent manner. The activities of superoxide dismutase and malondialdehyde in HK-2 cells increased significantly in the group exposed to PM. PM exposure decreased VDR and Nrf2, while increasing CYP27B1, renin, ACE, AT1, NF-kB, TNF-α, and IL-6. The expression of VDR, CYP27B1, renin, ACE, AT1, and TNF-α was reversed by paricalcitol treatment. Paricalcitol also restored the cell viability of PM-exposed HK-2 cells. Conclusion Our findings indicate that exposure to PM induces renal proximal tubular cell injury, concomitant with alteration of vitamin D endocrine system and renin angiotensin system. Vitamin D could attenuate renal tubular cell damage following PM exposure by suppressing the renin-angiotensin system and by partially inhibiting the inflammatory response.
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Affiliation(s)
- Eungu Kang
- Department of Pediatrics, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
| | - Hyung Eun Yim
- Department of Pediatrics, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
| | - Yoon Jeong Nam
- Medical Science Research Center, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
| | - Sang Hoon Jeong
- Medical Science Research Center, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
| | - Joo-Ae Kim
- Department of Earth and Environmental Sciences, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Ju-Han Lee
- Department of Pathology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, Gyeonggi 15355, South Korea
| | - Min Hwa Son
- Department of Pediatrics, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
| | - Kee Hwan Yoo
- Department of Pediatrics, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
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Chen SY, Hwang JS, Chan CC, Wu CF, Wu C, Su TC. Urban Air Pollution and Subclinical Atherosclerosis in Adolescents and Young Adults. J Adolesc Health 2022; 71:233-238. [PMID: 35537887 DOI: 10.1016/j.jadohealth.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/18/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The contribution of air pollution to subclinical atherosclerosis in a young population remains limited. This study aimed to assess whether long-term exposure to urban air pollutants increases carotid intima-media thickness (CIMT) in adolescents and young adults. METHODS This study included 789 subjects between the ages of 12 and 30 years who lived in the Taipei metropolis from a cohort of young Taiwanese individuals. Residential addresses were geocoded, and annual average concentrations of particulate matter (PM) of different diameters, e.g., PM10, PM2.5-10, PM2.5, and nitrogen oxides (NOX), were assessed using land use regression models. The generalized least squares strategy with error term to consider the cluster effect of living addresses between individuals was used to examine the associations between urban air pollution and CIMTs. RESULTS After adjusting for potential confounders, we found that interquartile range increases in PM2.5 (8.2 μg/m3) and NOX (17.5 μg/m3) were associated with 0.46% (95% CI: 0.02-0.90) and 1.00% (95% CI: 0.10-1.91) higher CIMTs, respectively. Stratified analyses showed that the relationships between CIMT and PM2.5 and NOX were more evident in subjects who were 18 years or older, female, nonsmoking, nonhypertensive, and nonhyperglycemic than in their respective counterparts. DISCUSSION Long-term exposure to PM2.5 and NOX is associated with subclinical atherosclerosis in a young population. Age, sex, and health status may influence the vulnerability of air pollution-associated subclinical atherosclerosis.
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Affiliation(s)
- Szu-Ying Chen
- Division of Occupational Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | | | - Chang-Chuan Chan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chang-Fu Wu
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Charlene Wu
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Chen Su
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; The Experimental Forest, National Taiwan University, Nantou, Taiwan.
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Ghazi L, Drawz PE, Berman JD. The association between fine particulate matter (PM 2.5) and chronic kidney disease using electronic health record data in urban Minnesota. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:583-589. [PMID: 34127789 PMCID: PMC8202050 DOI: 10.1038/s41370-021-00351-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Recent evidence has shown that fine particulate matter (PM2.5) may be an important environmental risk factor for chronic kidney disease (CKD), but few studies have examined this association for individual patients using fine spatial data. OBJECTIVE To investigate the association between PM2.5 and CKD (estimated glomerular filtration rate [eGFR]<45 ml/min/1.73 m2) in the Twin-Cities area in Minnesota using a large electronic health care database (2012-2019). METHODS We estimated the previous 1-year average PM2.5 from the first eGFR (measured with the CKD Epidemiology Collaboration equation using the first available creatinine measure during the baseline period [2012-2014]) using Environmental Protection Agency downscaler modeling data at the census tract level. We evaluated the spatial relative risk and clustering of CKD prevalence using a K-function test statistic. We assessed the prevalence ratio of the PM2.5 association with CKD incidence using a mixed effect Cox model, respectively. RESULTS Patients (n = 20,289) in the fourth (PM2.5 > 10.4), third (10.3 < PM2.5 < 10.8) and second quartile (9.9 < PM2.5 < 10.3) vs. the first quartile (<9.9 μg/m3) had a 2.52[2.21, 2.87], 2.18[1.95, 2.45], and 1.72[1.52, 1.97] hazard rate of developing CKD in the fully adjusted models, respectively. We identified spatial heterogeneities and evidence of CKD clustering across our study region, but this spatial variation was accounted for by air pollution and individual covariates. SIGNIFICANCE Exposure to higher PM2.5 is associated with a greater risk for incident CKD. Improvements in air quality, specifically at hotspots, may reduce CKD.
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Affiliation(s)
- Lama Ghazi
- Clinical and Translational Research Accelerator, Department of Medicine, Section of Nephrology, Yale University, New Haven, CT, USA.
| | - Paul E Drawz
- Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, MN, USA
| | - Jesse D Berman
- Division of Environmental Health Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Huang J, Zhang P, An Q, He L, Wang L. New insights into the treatment mechanisms of Vitamin D on PM2.5-induced toxicity and inflammation in mouse renal tubular epithelial cells. Int Immunopharmacol 2022; 108:108747. [DOI: 10.1016/j.intimp.2022.108747] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 12/21/2022]
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Jiang J, Ding S, Zhang G, Dong Y. Ambient particulate matter exposure plus a high-fat diet exacerbate renal injury by activating the NLRP3 inflammasome and TGF-β1/Smad2 signaling pathway in mice. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 238:113571. [PMID: 35512472 DOI: 10.1016/j.ecoenv.2022.113571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a public health problem of which the prevalence is increasing worldwide. Several studies have reported that ambient particulate matter (PM) causes kidney injury, which may be related to the risk of CKD. However, the underlying molecular mechanisms have not been fully clarified. In addition, whether a high-fat diet (HFD) could exacerbate ambient PM-induced nephrotoxicity has not been evaluated. This study aimed to investigate the combined effect of ambient PM and a HFD on renal injury. METHODS AND RESULTS Male C57BL/6 J mice were fed either a normal diet or a HFD and exposed to filtered air (FA) or particulate matter (PM) for 18 weeks. In the present study, we observed that renal function changed (serum blood urea nitrogen and serum creatinine), and exposure to PM and a HFD caused a synergistic effect on renal injury. Histopathological analysis showed that PM exposure induced renal fibrosis in mice, and combined exposure to PM and a HFD exacerbated these adverse effects. Moreover, ambient PM exposure activated the nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3) inflammasome and increased the inflammatory response, as indicated by the increases in interleukin-1β, interleukin-6 and tumor necrosis factor-α in the serum and kidney, as well as the upregulation of specific renal fibrosis-related markers (transforming growth factor-β1 and p-Smad2) in the kidney tissues of mice. Furthermore, combined exposure to PM and a HFD augmented these changes in the kidney. In vitro, inhibition of the NLRP3 inflammasome by MCC950 (an inhibitor of NLRP3) reduced the levels of proinflammatory cytokines and the expression of transforming growth factor-β1 and p-Smad2 in HK-2 cells. CONCLUSION Taken together, our data indicated that PM exposure caused renal inflammation and induced profibrotic effects on the kidney, and combined exposure to ambient PM and a HFD exacerbated renal injury, which may involve activation of the NLRP3 inflammasome and the TGF-β1/Smad2 signaling pathway.
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Affiliation(s)
- Jinjin Jiang
- Jiangsu Vocational College of Medicine, Yancheng, Jiangsu Province, PR China
| | - Shibin Ding
- Jiangsu Vocational College of Medicine, Yancheng, Jiangsu Province, PR China.
| | - Guofu Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, PR China
| | - Yaqi Dong
- Jiangsu Vocational College of Medicine, Yancheng, Jiangsu Province, PR China
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Chen SY, Wu CF, Wu C, Chan CC, Hwang JS, Su TC. Urban Fine Particulate Matter and Elements Associated with Subclinical Atherosclerosis in Adolescents and Young Adults. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7266-7274. [PMID: 35138845 DOI: 10.1021/acs.est.1c06347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The relationships between the elemental constituents of PM2.5 and atherosclerosis remain limited, especially in young populations. This study included 755 subjects aged 12-30 years in the Taipei metropolis. A land use regression model was used to estimate residential annual mean concentrations of PM2.5 and eight elemental constituents. We evaluated the percent differences in carotid intima-media thickness (CIMT) with PM2.5 and elemental constituent exposures by linear regressions. Interquartile range increments for PM2.5 (4.5 μg/m3), sulfur (108.6 ng/m3), manganese (2.0 ng/m3), iron (34.5 ng/m3), copper (3.6 ng/m3), and zinc (20.7 ng/m3) were found to associate with 0.92% (95% confidence interval (CI): 0.17-1.66), 0.51% (0.02-1.00), 0.36% (0.05-0.67), 0.98% (0.15-1.82), 0.74% (0.01-1.48), and 1.20% (0.33-2.08) higher CIMTs, respectively. Factor analysis identified four air pollution source-related factors, and the factors interpreted as traffic and industry sources were associated with higher CIMTs. Stratified analyses showed the estimates were more evident in subjects who were ≥18 years old, females, or who had lower household income. Our study results provide new insight into the impacts of source-specific air pollution, and future research on source-specific air pollution effects in young populations, especially in vulnerable subpopulations, is warranted.
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Affiliation(s)
- Szu-Ying Chen
- Division of Occupational Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Nursing, Fooyin University. Kaohsiung 831301, Taiwan
| | - Chang-Fu Wu
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
| | - Charlene Wu
- Global Health Program, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
| | - Chang-Chuan Chan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
| | - Jing-Shiang Hwang
- Institute of Statistical Science, Academia Sinica, Taipei 11529, Taiwan
| | - Ta-Chen Su
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 10002, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei 10002, Taiwan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
- The Experimental Forest, National Taiwan University, Nantou 557, Taiwan
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Lin HC, Hung PH, Hsieh YY, Lai TJ, Hsu HT, Chung MC, Chung CJ. Long-term exposure to air pollutants and increased risk of chronic kidney disease in a community-based population using a fuzzy logic inference model. Clin Kidney J 2022; 15:1872-1880. [PMID: 36158158 PMCID: PMC9494518 DOI: 10.1093/ckj/sfac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Indexed: 11/26/2022] Open
Abstract
Background Fuzzy inference systems (FISs) based on fuzzy theory in mathematics were previously applied to infer supplementary points for the limited number of monitoring sites and improve the uncertainty of spatial data. Therefore we adopted the FIS method to simulate spatiotemporal levels of air pollutants [particulate matter <2.5 μm (PM2.5), sulfur dioxide (SO2) and (NO2)] and investigated the association of levels of air pollutants with the community-based prevalence of chronic kidney disease (CKD). Methods A Complex Health Screening program was launched during 2012–2013 and a total of 8284 community residents in Chiayi County, which is located in southwestern Taiwan, received a series of standard physical examinations, including measurement of estimated glomerular filtration rate (eGFR). CKD cases were defined as eGFR <60 mL/min/1.73 m2 and were matched for age and gender in a 1:4 ratio of cases:controls. Data on air pollutants were collected from air quality monitoring stations during 2006–2016. The longitude, latitude and recruitment month of the individual case were entered into the trained FIS. The defuzzification process was performed based on the proper membership functions and fuzzy logic rules to infer the concentrations of air pollutants. In addition, we used conditional logistic regression and the distributed lag nonlinear model to calculate the prevalence ratios of CKD and the 95% confidence interval. Confounders including Framingham Risk Score (FRS), diabetes, gout, arthritis, heart disease, metabolic syndrome and vegetables consumption were adjusted in the models. Results Participants with a high FRS (>10%), diabetes, heart disease, gout, arthritis or metabolic syndrome had significantly increased CKD prevalence. After adjustment for confounders, PM2.5 levels were significantly increased in CKD cases in both single- and two-pollutant models (prevalence ratio 1.31–1.34). There was a positive association with CKD in the two-pollutant models for NO2. However, similar results were not observed for SO2. Conclusions FIS may be helpful to reduce uncertainty with better interpolation for limited monitoring stations. Meanwhile, long-term exposure to ambient PM2.5 appears to be associated with an increased prevalence of CKD, based on a FIS model.
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Affiliation(s)
- Hsueh-Chun Lin
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Peir-Haur Hung
- Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Yun-Yu Hsieh
- Department of Health Risk Management, China Medical University, Taichung, Taiwan
| | - Ting-Ju Lai
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Hui-Tsung Hsu
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chi-Jung Chung
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Xue B, Wang B, Lei R, Li Y, Luo B, Yang A, Zhang K. Indoor solid fuel use and renal function among middle-aged and older adults: A national study in rural China. ENVIRONMENTAL RESEARCH 2022; 206:112588. [PMID: 34951991 DOI: 10.1016/j.envres.2021.112588] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 05/26/2023]
Abstract
Solid fuel use is the main source of indoor air pollution, especially in rural areas of developing countries. Nevertheless, the evidence linking indoor solid fuel use and renal function is very limited. Therefore, we investigated the association between indoor solid fuel use and renal function among middle-aged and older adults in rural China. Cystatin C (CysC) concentration of each participant was used to calculate the estimated glomerular filtration rate (eGFR). We used the baseline data to investigate the associations between solid fuel use for cooking and heating and eGFR through a linear-mixed effects model. Then, we applied the generalized linear-mixed effects model with binary distribution to examine the relationship between renal function decline and cooking fuel switching from 2011 to 2015. A total of 4959 participants were included at baseline, and 3536 participants were included in the follow-up analysis. Compared to participants who used clean fuel for both cooking and heating, the eGFR was significantly lower among participants who cooked with solid fuel and heated with clean fuel (β: -2.81; 95% CI: -5.53, -0.09). In the follow-up analysis, the risks of renal function decline for participants using solid fuel for cooking were significantly higher in males (OR: 2.74; 95% CI: 1.68, 4.49), smokers (OR: 5.70; 95% CI: 2.82, 11.55), and drinkers (OR: 7.11; 95% CI: 3.15, 16.02) compared to females, non-smokers, and non-drinkers. Moreover, 45-65 years aged participants (OR: 0.54; 95% CI: 0.33, 0.89) and non-drinkers (OR: 0.61; 95% CI: 0.41, 0.92) who switched from solid to clean cooking fuel had a lower risk of renal function decline. In conclusion, our findings show that household solid fuel use is likely to be an important risk factor for renal function decline in rural China. And switching to cleaner fuel may provide significant public health benefits.
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Affiliation(s)
- Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Yanlin Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China.
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY, 12144, USA.
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Wu YH, Wu CD, Chung MC, Chen CH, Wu LY, Chung CJ, Hsu HT. Long-Term Exposure to Fine Particulate Matter and the Deterioration of Estimated Glomerular Filtration Rate: A Cohort Study in Patients With Pre-End-Stage Renal Disease. Front Public Health 2022; 10:858655. [PMID: 35462847 PMCID: PMC9024125 DOI: 10.3389/fpubh.2022.858655] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/11/2022] [Indexed: 12/01/2022] Open
Abstract
Limited literature has explored the effect of air pollutants on chronic kidney disease (CKD) progression, especially for patients with pre-end-stage renal disease (pre-ESRD). In this study, we reported the linear and nonlinear relationships of air pollutants of particles with diameter <2.5 μm (PM2.5) and nitrogen dioxide (NO2) with estimated glomerular filtration rate (eGFR) deterioration after adjusting for smoking status and other traditional clinical factors. This study adopted a retrospective cohort of patients with stage 3b to stage 5 CKD (N = 11,479) from Taichung Veterans General Hospital during January 2006 to December 2020. The eGFR deterioration was defined as a decline in eGFR > 5 ml/min/1.73 m2/year. Hybrid kriging/land-use regression models were used to estimate the individual exposure levels of PM2.5 and NO2. The relationships of air pollutants with eGFR deterioration were evaluated using Cox proportional hazard models. After adjusting for smoking status, baseline eGFR stages, and other traditional clinical factors, the risk of eGFR deterioration was found to increase with increasing PM2.5 and NO2 level (p < 0.0001 and p = 0.041, respectively), especially for those exposed to PM2.5 ≥ 31.44 μg/m3 or NO2 ≥ 15.00 ppb. Similar results were also found in the two-pollutant models. Nonlinear dose-response relationships of eGFR deterioration were observed for concentrations of 26.11 μg/m3 for PM2.5 and 15.06 ppb for NO2. In conclusion, linear and nonlinear associations between PM2.5 and NO2 levels and the incidence risk of eGFR deterioration were observed in patients with pre-ESRD.
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Affiliation(s)
- Yu-Hsien Wu
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
- Adjunct Associate Research Fellow, National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Laing-You Wu
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chi-Jung Chung
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Hui-Tsung Hsu
- Department of Public Health, China Medical University, Taichung, Taiwan
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Peng S, Lu T, Liu Y, Li Z, Liu F, Sun J, Chen M, Wang H, Xiang H. Short-term exposure to fine particulate matter and its constituents may affect renal function via oxidative stress: A longitudinal panel study. CHEMOSPHERE 2022; 293:133570. [PMID: 35007609 PMCID: PMC8976286 DOI: 10.1016/j.chemosphere.2022.133570] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 05/06/2023]
Abstract
Exposure to fine particulate matter (PM2.5) has been reported to increase the risks of chronic kidney disease. However, limited research has assessed the effect of PM2.5 and its constituents on renal function, and the underlying mechanism has not been well characterized. We aimed to evaluate the association of PM2.5 and its constituents with kidney indicators and to explore the roles of systematic oxidative stress and inflammation in the association. We conducted a longitudinal panel study among 35 healthy adults before-, intra- and after-the 2019 Wuhan Military World Games. We repeatedly measured 6 renal function parameters and 5 circulating biomarkers of oxidative stress and inflammation at 6 rounds of follow-ups. We monitored hourly personal PM2.5 concentrations with 3 consecutive days and measured 10 metals (metalloids) and 16 polycyclic aromatic hydrocarbons (PAHs) components. The linear mixed-effect models were applied to examine the association between PM2.5 and renal function parameters, and the mediation analysis was performed to explore potential bio-pathways. PM2.5 concentrations across Wuhan showed a slight decrease during the Military Games. We observed significant associations between elevated blood urea nitrogen (BUN) levels and PM2.5 and its several metals and PAHs components. For an interquartile range (IQR) increase of PM2.5, BUN increased 0.42 mmol/L (95% CI: 0.14 to 0.69). On average, an IQR higher of lead (Pb), cadmium (Cd), arsenic (As), selenium (Se), thallium (Tl) and Indeno (1,2,3-cd) pyrene (IPY) were associated with 0.90, 0.65, 0.29, 0.27, 0.26 and 0.90 mmol/L increment of BUN, respectively. Moreover, superoxide dismutase was positively associated with PM2.5 and mediated 18.24% association. Our research indicated that exposure to PM2.5 might affect renal function by activating oxidative stress pathways, in which the constituents of Pb, Cd, As, Se, Tl and IPY might contribute to the associations.
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Affiliation(s)
- Shouxin Peng
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Tianjun Lu
- Department of Earth Science and Geography, California State University Dominguez Hills, 1000 E. Victoria St, Carson, CA, 90747, USA
| | - Yisi Liu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98105, USA
| | - Zhaoyuan Li
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Feifei Liu
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Jinhui Sun
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Meijin Chen
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Huaiji Wang
- Wuhan Center for Disease Control and Prevention, 288# Machang Road, Wuhan, 430024, China.
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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Health Effects of Long-Term Exposure to Ambient PM 2.5 in Asia-Pacific: a Systematic Review of Cohort Studies. Curr Environ Health Rep 2022; 9:130-151. [PMID: 35292927 PMCID: PMC9090712 DOI: 10.1007/s40572-022-00344-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/21/2022]
Abstract
Abstract Purpose of Review Health effects of long-term exposure to ambient PM2.5 vary with regions, and 75% of the deaths attributable to PM2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM2.5 in Asia-Pacific. Recent Findings In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM2.5-health associations. Summary To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM2.5 exposure in understudied regions, the health effects of long-term PM2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM2.5-health associations. Study design, especially exposure assessment methods, should be improved. Supplementary Information The online version contains supplementary material available at 10.1007/s40572-022-00344-w.
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Remigio RV, He H, Raimann JG, Kotanko P, Maddux FW, Sapkota AR, Liang XZ, Puett R, He X, Sapkota A. Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152481. [PMID: 34921874 PMCID: PMC8962569 DOI: 10.1016/j.scitotenv.2021.152481] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Increasing number of studies have linked air pollution exposure with renal function decline and disease. However, there is a lack of data on its impact among end-stage kidney disease (ESKD) patients and its potential modifying effect from extreme heat events (EHE). METHODS Fresenius Kidney Care records from 28 selected northeastern US counties were used to pool daily all-cause mortality (ACM) and all-cause hospital admissions (ACHA) counts. County-level daily ambient PM2.5 and ozone (O3) were estimated using a high-resolution spatiotemporal coupled climate-air quality model and matched to ESKD patients based on ZIP codes of treatment sites. We used time-stratified case-crossover analyses to characterize acute exposures using individual and cumulative lag exposures for up to 3 days (Lag 0-3) by using a distributed lag nonlinear model framework. We used a nested model comparison hypothesis test to evaluate for interaction effects between air pollutants and EHE and stratification analyses to estimate effect measures modified by EHE days. RESULTS From 2001 to 2016, the sample population consisted of 43,338 ESKD patients. We recorded 5217 deaths and 78,433 hospital admissions. A 10-unit increase in PM2.5 concentration was associated with a 5% increase in ACM (rate ratio [RRLag0-3]: 1.05, 95% CI: 1.00-1.10) and same-day O3 (RRLag0: 1.02, 95% CI: 1.01-1.03) after adjusting for extreme heat exposures. Mortality models suggest evidence of interaction and effect measure modification, though not always simultaneously. ACM risk increased up to 8% when daily ozone concentrations exceeded National Ambient Air Quality Standards established by the United States, but the increases in risk were considerably higher during EHE days across lag periods. CONCLUSION Our findings suggest interdependent effects of EHE and air pollution among ESKD patients for all-cause mortality risks. National level assessments are needed to consider the ESKD population as a sensitive population and inform treatment protocols during extreme heat and degraded pollution episodes.
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Affiliation(s)
- Richard V Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Hao He
- Department of Atmospheric and Oceanic Sciences, University of Maryland, College Park, MD, USA
| | | | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Amy Rebecca Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin-Zhong Liang
- Department of Atmospheric and Oceanic Sciences, University of Maryland, College Park, MD, USA; Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
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Xi Y, Richardson DB, Kshirsagar AV, Wade TJ, Flythe JE, Whitsel EA, Peterson GC, Wyatt LH, Rappold AG. Effects of short-term ambient PM 2.5 exposure on cardiovascular disease incidence and mortality among U.S. hemodialysis patients: a retrospective cohort study. Environ Health 2022; 21:33. [PMID: 35277178 PMCID: PMC8917758 DOI: 10.1186/s12940-022-00836-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/25/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND Ambient PM2.5 is a ubiquitous air pollutant with demonstrated adverse health impacts in population. Hemodialysis patients are a highly vulnerable population and may be particularly susceptible to the effects of PM2.5 exposure. This study examines associations between short-term PM2.5 exposure and cardiovascular disease (CVD) and mortality among patients receiving maintenance in-center hemodialysis. METHODS Using the United State Renal Data System (USRDS) registry, we enumerated a cohort of all US adult kidney failure patients who initiated in-center hemodialysis between 1/1/2011 and 12/31/2016. Daily ambient PM2.5 exposure estimates were assigned to cohort members based on the ZIP code of the dialysis clinic. CVD incidence and mortality were ascertained through 2016 based on USRDS records. Discrete time hazards regression was used to estimate the association between lagged PM2.5 exposure and CVD incidence, CVD-specific mortality, and all-cause mortality 1 t adjusting for temperature, humidity, day of the week, season, age at baseline, race, employment status, and geographic region. Effect measure modification was assessed for age, sex, race, and comorbidities. RESULTS Among 314,079 hemodialysis patients, a 10 µg/m3 increase in the average lag 0-1 daily PM2.5 exposure was associated with CVD incidence (HR: 1.03 (95% CI: 1.02, 1.04)), CVD mortality (1.05 (95% CI: 1.03, 1.08)), and all-cause mortality (1.04 (95% CI: 1.03, 1.06)). The association was larger for people who initiated dialysis at an older age, while minimal evidence of effect modification was observed across levels of sex, race, or baseline comorbidities. CONCLUSIONS Short-term ambient PM2.5 exposure was positively associated with incident CVD events and mortality among patients receiving in-center hemodialysis. Older patients appeared to be more susceptible to PM2.5-associated CVD events than younger hemodialysis patients.
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Affiliation(s)
- Yuzhi Xi
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Public Health and Environmental Assessment, Oak Ridge Institute for Science and Education at the United States Environmental Protection Agency, Chapel Hill, NC, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abhijit V Kshirsagar
- Division of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, University of North Carolina Kidney Center, Chapel Hill, NC, USA
| | - Timothy J Wade
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, NC, USA
| | - Jennifer E Flythe
- Division of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, University of North Carolina Kidney Center, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Geoffrey C Peterson
- Center for Public Health and Environmental Assessment Public Health, Chemical and Pollution Assessment Division, United States Environmental Protection Agency, Washington, DC, USA
| | - Lauren H Wyatt
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, NC, USA
| | - Ana G Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, NC, USA.
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Xu W, Wang S, Jiang L, Sun X, Wang N, Liu X, Yao X, Qiu T, Zhang C, Li J, Deng H, Yang G. The influence of PM 2.5 exposure on kidney diseases. Hum Exp Toxicol 2022; 41:9603271211069982. [PMID: 35174736 DOI: 10.1177/09603271211069982] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The harm of air pollution to public health has become a research hotspot, especially atmospheric fine-particulate matter (PM2.5). In recent years, epidemiological investigations have confirmed that PM2.5 is closely related to chronic kidney disease and membranous nephropathy Basic research has demonstrated that PM2.5 has an impact on the normal function of the kidneys through accumulation in the kidney, endothelial dysfunction, abnormal renin-angiotensin system, and immune complex deposition. Moreover, the mechanism of PM2.5 damage to the kidney involves inflammation, oxidative stress, apoptosis, DNA damage, and autophagy. In this review, we summarized the latest developments in the effects of PM2.5 on kidney disease in human and animal studies, so as to provide new ideas for the prevention and treatment of kidney disease.
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Affiliation(s)
- Wenqi Xu
- Department of Food Nutrition and Safety, 36674Dalian Medical University, Dalian, China
| | - Shaopeng Wang
- Department of Cardiology, 74710First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liping Jiang
- Liaoning Anti-degenerative Diseases Natural Products Engineering Technology Research Center, 36674Dalian Medical University, Dalian, China
| | - Xiance Sun
- Liaoning Anti-degenerative Diseases Natural Products Engineering Technology Research Center, 36674Dalian Medical University, Dalian, China
| | - Ningning Wang
- Department of Food Nutrition and Safety, 36674Dalian Medical University, Dalian, China
| | - Xiaofang Liu
- Department of Food Nutrition and Safety, 36674Dalian Medical University, Dalian, China
| | - Xiaofeng Yao
- Liaoning Anti-degenerative Diseases Natural Products Engineering Technology Research Center, 36674Dalian Medical University, Dalian, China
| | - Tianming Qiu
- Liaoning Anti-degenerative Diseases Natural Products Engineering Technology Research Center, 36674Dalian Medical University, Dalian, China
| | - Cong Zhang
- Department of Food Nutrition and Safety, 36674Dalian Medical University, Dalian, China
| | - Jing Li
- Department of Pathology, 36674Dalian Medical University, Dalian, China
| | - Haoyuan Deng
- Department of Food Nutrition and Safety, 36674Dalian Medical University, Dalian, China
| | - Guang Yang
- Department of Food Nutrition and Safety, 36674Dalian Medical University, Dalian, China
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Rasking L, Vanbrabant K, Bové H, Plusquin M, De Vusser K, Roels HA, Nawrot TS. Adverse Effects of fine particulate matter on human kidney functioning: a systematic review. Environ Health 2022; 21:24. [PMID: 35135544 PMCID: PMC8822715 DOI: 10.1186/s12940-021-00827-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/27/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Ambient fine particulate matter (PM < 2.5 μm, PM2.5) is gaining increasing attention as an environmental risk factor for health. The kidneys are considered a particularly vulnerable target to the toxic effects that PM2.5 exerts. Alteration of kidney function may lead to a disrupted homeostasis, affecting disparate tissues in the body. This review intends to summarize all relevant knowledge published between January 2000 and December 2021 on the effects of ambient PM2.5 and the adverse effects on kidney function in adults (≥ 18 years). RESULTS AND DISCUSSION Studies published in peer-reviewed journals, written in English, regarding the effects of PM2.5 on kidney function and the development and/or exacerbation of kidney disease(s) were included. Of the 587 nonduplicate studies evaluated, 40 were included, comprising of studies on healthy or diagnosed with pre-existing disease (sub)populations. Most of the studies were cohort studies (n = 27), followed by 10 cross-sectional, 1 ecological and 2 time-series studies. One longitudinal study was considered intermediate risk of bias, the other included studies were considered low risk of bias. A large portion of the studies (n = 36) showed that PM2.5 exposure worsened kidney outcome(s) investigated; however, some studies show contradictory results. Measurement of the estimated glomerular filtration rate, for instance, was found to be positively associated (n = 8) as well as negatively associated (n = 4) with PM2.5. LIMITATIONS AND CONCLUSION The main limitations of the included studies include residual confounding (e.g., smoking) and lack of individual exposure levels. The majority of included studies focused on specific subpopulations, which may limit generalizability. Evidence of the detrimental effects that ambient PM2.5 may exert on kidney function is emerging. However, further investigations are required to determine how and to what extent air pollution, specifically PM2.5, exerts adverse effects on the kidney and alters its function. REGISTRATION The systematic review protocol was submitted and published by the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020175615 ).
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Affiliation(s)
- Leen Rasking
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, B-3590, Diepenbeek, Belgium
| | - Kenneth Vanbrabant
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, B-3590, Diepenbeek, Belgium
| | - Hannelore Bové
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, B-3590, Diepenbeek, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, B-3590, Diepenbeek, Belgium
| | - Katrien De Vusser
- Nephrology and Kidney Transplantation, University Hospital Leuven, Leuven, Belgium
- Department of Microbiology, Immunology, and Transplantation, Leuven University, Leuven, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, B-3590, Diepenbeek, Belgium
- Louvain Centre for Toxicology and Applied Pharmacology, Université catholique de Louvain, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, B-3590, Diepenbeek, Belgium.
- Department of Public Health and Primary Care, Environment and Health Unit, Leuven University, Leuven, Belgium.
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Han Y, Xue T, Kelly FJ, Zheng Y, Yao Y, Li J, Li J, Fan C, Li P, Zhu T. Association of PM 2.5 Reduction with Improved Kidney Function: A Nationwide Quasiexperiment among Chinese Adults. HEALTH DATA SCIENCE 2022; 2022:9846805. [PMID: 38487491 PMCID: PMC10904065 DOI: 10.34133/2022/9846805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/20/2021] [Indexed: 03/17/2024]
Abstract
Background. Increasing evidence from human studies has revealed the adverse impact of ambient fine particles (PM 2.5) on health outcomes related to metabolic disorders and distant organs. Whether exposure to ambient PM 2.5 leads to kidney impairment remains unclear. The rapid air quality improvement driven by the clean air actions in China since 2013 provides an opportunity for a quasiexperiment to investigate the beneficial effect of PM 2.5 reduction on kidney function.Methods. Based on two repeated nationwide surveys of the same population of 5115 adults in 2011 and 2015, we conducted a difference-in-difference study. Variations in long-term exposure to ambient PM 2.5 were associated with changes in kidney function biomarkers, including estimated glomerular filtration rate by serum creatinine (GFR scr) or cystatin C (GFR cys), blood urea nitrogen (BUN), and uric acid (UA).Results. For a 10 μg/m 3 reduction in PM 2.5, a significant improvement was observed for multiple kidney functional biomarkers, including GFR scr, BUN and UA, with a change of 0.42 (95% confidence interval [CI]: 0.06, 0.78) mL/min/1.73m 2, -0.38 (-0.64, -0.12) mg/dL, and -0.06 (-0.12, -0.00) mg/dL, respectively. A lower socioeconomic status, indicated by rural residence or low educational level, enhanced the adverse effect of PM 2.5 on kidney function.Conclusions. These results support a significant nephrotoxicity of PM 2.5 based on multiple serum biomarkers and indicate a beneficial effect of improved air quality on kidney function.
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Affiliation(s)
- Yiqun Han
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing 100871, China
| | - Tao Xue
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Frank J. Kelly
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Yixuan Zheng
- Center of Air Quality Simulation and System Analysis, Chinese Academy of Environmental Planning, 100012 Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jiajianghui Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jiwei Li
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Chun Fan
- Computer Center, Peking University and Peng Cheng Laboratory, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, China
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health, Peking University, Beijing 100871, China
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50
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Kumar S, Jain MK. Interrelationship of Indoor Particulate Matter and Respiratory Dust Depositions of Women in the Residence of Dhanbad City, India. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:4668-4689. [PMID: 34414538 DOI: 10.1007/s11356-021-15584-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
Women spend relatively more time in indoor environments in developing countries. Exposure to various indoor air pollutants leads them to higher health risks according to household air quality in which they reside. Particulate matter (PM) exposure with their exposure duration inside the household plays a significant role in women's respiratory problems. This study measured size-segregated particulate matter concentrations in 63 residences at different locations. Respiratory dust depositions (RDDs) for 118 women in their different respiratory regions like head airway (HD), tracheobronchial (TB), and alveolar (AL) regions for the three PM size fractions (PM10, PM2.5, and PM1) were investigated. For different positions like light exercise and the sitting condition, RDDs values found for AL region were 0.091 μgmin-1 (SD: 0.067, 0.012-0.408) and 0.028 μgmin-1 (SD: 0.021, 0.003-0.126) for PM10, 0.325 μgmin-1 (SD: 0.254, 0.053-1.521) and 0.183 μgmin-1 (SD: 0.143, 0.031-0.857) for PM2.5, 0.257 μgmin-1 (SD: 0.197, 0.043-1.04) and 0.057 μgmin-1 (SD: 0.044, 0.009-0.233) respectively for PM1 to females. RDDs values in the AL region significantly increase as PM10 (11%), PM2.5 (68%), and PM1 (21%), confirming that for women, the AL region is the most prominent affected zone by fine particles (PM2.5).
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Affiliation(s)
- Shravan Kumar
- Department of Environmental Science and Engineering, Indian Institute of Technology (Indian School of Mines), Dhanbad, Jharkhand, 826004, India
| | - Manish Kumar Jain
- Department of Environmental Science and Engineering, Indian Institute of Technology (Indian School of Mines), Dhanbad, Jharkhand, 826004, India.
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