ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: PO0019

Higher Ambient Level of Nitrogen Dioxide Is Associated with an Increased Risk of AKI

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Xu, Xin, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
  • Li, Yanqin, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
  • Su, Licong, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
  • Hou, Fan Fan, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China

Group or Team Name

  • Xin Xu

Previous studies have suggested that long-term exposure to air pollution increased the risk of chronic kidney disease and its progression. However, the effect of air pollution on the risk of acute kidney injury (AKI) has not been studied.


We selected from the Epidemiology of AKI in Chinese Hospitalized patients (EACH2 study) AKI cases of which the onset date could be unambiguously determined. We obtained city-specific daily averages of the ambient level of PM2.5, PM10, CO, NO2, SO2 and O3, from the Ministry of Environmental Protection of China. We used the time-stratified case crossover approach to examine the association between the ambient level of air pollutants and the risk of AKI in the selected cases.


A total of 11,293 AKI cases that met the inclusion and exclusion criteria were selected, of which, 3175 (28.1%) were severe AKI (stage 2 or 3). In univariable analysis, the ambient levels of NO2 and SO2, were significantly associated with the risk of AKI. In the multivariable analysis that incorporated all six pollutants in the same model, NO2 was the sole pollutant whose level remained to be associated with the risk of AKI (p<0.001). The relationship between level of NO2and the risk of AKI appeared to be linear, with an estimated odds ratio of 1.072 (95% CI: 1.033, 1.113) for each increment of one standard deviation in the exposure. The association was consistent across the subgroups stratified by age, gender, baseline eGFR, AKI severity, need for intensive care, and season.


Higher ambient level of NO2 was associated with an increased risk of AKI in hospitalized adults in China.