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Kidney Week

Abstract: FR-OR052

Particulate Matter, Albuminuria, and CKD: The ARIC Study

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Blum, Matthew F., Johns Hopkins University, Baltimore, Maryland, United States
  • Surapaneni, Aditya L., Johns Hopkins University, Baltimore, Maryland, United States
  • Stewart, James, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Liao, Duanping, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
  • Yanosky, Jeff D., Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
  • Whitsel, Eric A., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Power, Melinda, George Washington University, Washington, District of Columbia, United States
  • Grams, Morgan, Johns Hopkins University, Baltimore, Maryland, United States
Background

Exposure to particulate matter less than 2.5 mm in diameter (PM2.5) has been linked to detrimental health effects. This study describes the relationship between long-term exposure to PM2.5 and estimated glomerular filtration rate (eGFR), albuminuria, and incident chronic kidney disease (CKD).

Methods

The study included 10,856 participants from the Atherosclerosis Risk in Communities cohort followed from 1996 through 2017. Monthly mean PM2.5 concentrations (ug/m3) were estimated at participant addresses, then averaged over 12-, 60-, and 120-month periods preceding participant examination. Covariate-adjusted cross-sectional associations of PM2.5 with eGFR and log-transformed urinary albumin-creatinine ratio (ACR) were estimated using linear regression. PM2.5-incident CKD associations were estimated using Cox proportional hazards regression. Modeling was stratified by ARIC site, and stratum-specific estimates were combined in random-effects meta-analyses.

Results

There was no significant PM2.5-eGFR association at any exposure averaging period. PM2.5 averaged over the 12- and 60-, but not 120-month periods was associated with higher log(ACR) after adjusting for demographics, socioeconomic status, and clinical covariates. Incident CKD was higher with higher 12-, but not 60- and 120-month mean PM2.5 concentrations (Table).

Conclusion

Exposure to higher 12- and 60-month mean PM2.5 concentrations was associated with higher albuminuria, and exposure to higher 12-month mean PM2.5 concentration was associated with higher risk for incident CKD.

Adjustment modeleGFR, β (CI)log(ACR), β (CI)Incident CKD, HR (CI)
12-month: Model 12.05 (-2.62, 6.73)0.80 (0.33, 1.27)†1.96 (1.31, 2.93)†
12-month: Model 20.98 (-2.45, 4.40)0.66 (0.26, 1.05)†1.95 (1.14, 3.33)†
60-month: Model 1-1.26 (-4.80, 2.28)0.39 (0.05, 0.73)†1.79 (1.08, 2.96)†
60-month: Model 2-1.16 (-4.77, 2.44)0.36 (0.03, 0.70)†1.77 (0.92, 3.40)†
120-month: Model 1-1.01 (-4.64, 2.61)0.08 (-0.41, 0.58)1.20 (0.73, 1.98)
120-month: Model 2-0.72 (-4.40, 2.97)0.08 (-0.37, 0.53)1.14 (0.64, 2.00)

Model 1: sex, age, race, neighborhood socioeconomic score, family income, and education level. Model 2: Model 1 + body mass index, diabetes mellitus, hypertension, coronary heart disease, cigarette smoking, eGFR,* urinary ACR,** C-reactive protein, and temperature. Covariate omitted for eGFR outcome (*) and log(ACR) outcome (**). † signifies P < 0.05. CI, confidence interval; HR, hazard ratio.