Abstract: SA-OR056

The Global Burden of Kidney Disease Attributable to Air Pollution

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Bowe, Benjamin Charles, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States
  • Xie, Yan, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States
  • Xian, Hong, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States
  • Li, Tingting, Washington University in St. Louis, Saint Louis, Missouri, United States
  • Al-Aly, Ziyad, Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St Louis Health Care System, St. Louis, Missouri, United States
Background

We previously described an association between increased levels of fine particulate matter of <2.5 µm in aerodynamic diameter (PM2.5) and risk of incident chronic kidney disease (CKD). This work aims to provide a quantitative assessment of the global burden of CKD attributable to elevated levels of PM2.5.

Methods

We used the Global Burden of Disease (GBD) study methodologies to estimate the burden of CKD attributable to air pollution using the following measures: attributable burden of disease (ABD), years living with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALY). Relative risk was derived from our prior work. Population weighted PM2.5 levels and incident rates of CKD for each country were curated from the GBD study publicly available data sources.

Results

Our estimate for the global annual burden of incident CKD attributable to elevated PM2.5 was 10,784,514 (95% Uncertainty Interval: 7,821,109-13,857,623). YLD, YLL, and DALYs of CKD attributable to elevated PM2.5 were 2,185,317 (1,418,442-3,061,477), 7,897,941 (5,471,081-10,514,433), and 10,083,258 (7,064,399-13,323,685), respectively. Standardized ABD in the 10 most populated countries showed Nigeria, Bangladesh, Pakistan, and India having high ABDs, exceeding 200 incident cases of CKD per 100,000 population. Populations in Mexico, Central America, Southeast Asia, India, and Northern Africa were amongst those with highest DALYs. For example, DALYs per 100,000 were 366.71 (251.05, 498.01) in Nicaragua and 353.93 (260.05-449.24) in Mexico, compared to 44.59 (24.07-65.74) in the United States.

Conclusion

The global toll of CKD attributable to air pollution is significant. The burden varies substantially by geography. Air pollution might at least partially explain the rise in incidence of CKD of unknown cause in many geographies around the world, and the rise in Mesoamerican nephropathy in Mexico, and Central America.

The global burden of chronic kidney disease attributable to elevated PM2.5. expressed in disability adjusted life years (DALY) per 100,000 population.

Funding

  • Veterans Affairs Support