Kidney Week

Abstract: FR-PO397

Ambient Coarse Particulate Matter, Nitrogen Dioxide, Carbon Monoxide, and the Risk of Kidney Disease

Session Information

• CKD: Risk Factors for Incidence and Progression - I
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 301 CKD: Risk Factors for Incidence and Progression

Authors

• Bowe, Benjamin Charles, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States

Benjamin Charles Bowe,

• Xie, Yan, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States

Yan Xie,

• Li, Tingting, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States

Tingting Li,

• Yan, Yan, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States

Yan Yan,

• Xian, Hong, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States

Hong Xian,

• Al-Aly, Ziyad, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States

Ziyad Al-Aly,

Background

Experimental and preliminary clinical evidence suggest that environmental air pollution adversely impacts kidney health. Prior work examined the association between fine particulate matter and risk of kidney disease. The relationship between ambient coarse particulate matter (PM₁₀), nitrogen dioxide (NO₂), and carbon monoxide (CO) and risk of incident chronic kidney disease (CKD), CKD progression, and end stage renal disease (ESRD) is not clear.

Methods

We merged multiple large databases including those of the Environmental Protection Agency and the Department of Veterans Affairs to build a longitudinal observational cohort of 2,201,969 United States veterans, and used survival models to evaluate the association of PM₁₀, NO₂, and CO concentrations and risk of incident eGFR <60 ml/min/1.73m², incident CKD, eGFR decline ≥30%, and ESRD. Exposure was treated as time-varying where it was updated annually and as cohort participants moved.

Results

Over a median follow-up of 8.52 years (IQR:8.05-8.80), an interquartile range (IQR) increase in concentrations of PM₁₀, NO₂, and CO was associated with increased risk of eGFR <60 ml/min/1.73m², HR=1.07 (CI=1.06-1.08), HR=1.09 (CI=1.08-1.10), and HR=1.09 (CI=1.08-1.10), respectively. An IQR increase in concentrations of PM₁₀, NO₂, and CO was associated with increased risk of incident CKD, HR= 1.07; (CI=1.05-1.08), HR=1.09; (CI=1.08-1.11), and HR=1.10; CI=1.08-1.11), respectively. An IQR increase in PM₁₀, NO₂, and CO concentrations was associated with increased risk of eGFR decline ≥30%; HR=1.08 (CI=1.07-1.09), HR=1.12 (CI=1.10-1.13), HR=1.09 (CI=1.08-1.10), respectively. An IQR increase in concentrations of PM₁₀, NO₂, and CO was associated with increased risk of ESRD; HR=1.09 (CI=1.06-1.12), HR=1.09 (CI=1.06-1.12), and HR=1.05 (CI=1.02-1.08), respectively. Spline analyses suggested a monotonic increasing relationship between PM₁₀, NO₂, and CO concentrations and risk of kidney outcomes.

Conclusion

Our results demonstrate that environmental exposure to higher levels of PM₁₀, NO₂, and CO is associated with increased risk of incident CKD, eGFR decline, and ESRD.

Funding

• Veterans Affairs Support