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Abstract: PO0477

Association Between Air Pollution and Renal Outcomes: A Systematic Review and Meta-Analysis

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Hamroun, Aghiles, Centre Hospitalier Regional Universitaire de Lille, Lille, Hauts-de-France, France
  • Camier, Aurore, INSERM, UMR1153 Center for Research in Epidemiology and StatisticS (CRESS), Research Team on Early Life Origins of Health (EAROH), Paris, France
  • Bigna, Jean Joel, Centre Pasteur, Yaounde, Cameroon
  • Glowacki, François, Centre Hospitalier Regional Universitaire de Lille, Lille, Hauts-de-France, France
Background

Although several risk factors of chronic kidney disease (CKD) have been well-established, mainly diabetes and hypertension, many remain less studied, such as chronic exposure to air pollution. Our purpose is to exhaustively summarize the current evidence on the association between air pollution and various renal outcomes.

Methods

We searched EMBASE, Pubmed, Web of Science, Cochrane library, and CINAHL database, for relevant records using a combination of keywords related to the type of exposure (O3, CO, NOx, NO2, SO2, PM2.5, PMcoarse, and PM10) and outcome (CKD, end-stage renal disease -ESRD-, proteinuria/albuminuria, renal function, kidney transplant failure, nephrotic syndrome, and kidney cancer). Using random-effects meta-analyses, we pooled summary statistics (hazard ratios, odds ratios, or beta-coefficients with their respective 95% confidence intervals) associated with a standardized increased level of each pollutant and presented the results by air pollutant and outcome. Heterogeneity has been assessed using the χ2 test on Cochran’s Q statistic and quantified I2 calculation.

Results

Within 1214 eligible studies, 42 articles fulfilling the selection criteria were included in this work (11 cross-sectional, 15 prospective, and 16 retrospective cohort studies). The most significant associations are for PM2.5 exposure and higher risks of CKD, ESRD, and kidney cancer incidence (HR=1.24 [1.15; 1.34]; 1.27 [1.18; 1.36]; 1.26 [1.02; 1.57] respectively, per 10µg/m3 increased level); NO2 exposure and higher risks of CKD and ESRD incidence; PM10 /PMcoarse exposure and higher CKD prevalence, as well as lower renal function (see details in Figure 1). These results should however be interpreted with caution, due to significant between-studies heterogeneity and risks of methodological bias.

Conclusion

Chronic exposure to particulate matter and nitrite dioxide seems to be associated with poorer renal outcomes. Further studies are warranted to confirm these results.