Ta-Chien Chan 1 , 2 , Zilong Zhang 3 , Bo-Cheng Lin 1 , 4 , Changqing Lin 5 , 6 , Han-Bing Deng 3 , Yuan Chieh Chuang 7 , Jimmy W.M. Chan 8 , Wun Kai Jiang 7 , Tony Tam 9 , Ly-yun Chang 7 , 10 , Gerard Hoek 11 , Alexis K.H. Lau 6 , 8 , Xiang Qian Lao , 3 , 12
15 October 2018
Chronic kidney disease (CKD) is a serious global public health challenge, but there is limited information on the connection between air pollution and risk of CKD.
The aim of this study was to investigate the association between long-term exposure to particulate matter (PM) with an aerodynamic diameter of less than ( ) and the development of CKD in a large cohort.
A total of 100,629 nonCKD Taiwanese residents age 20 y or above were included in this study between 2001 and 2014. Ambient concentration was estimated at each participant’s address using a satellite-based spatiotemporal model. Incident CKD cases were identified by an estimated glomerular filtration rate (eGFR) of less than . We collected information on a wide range of potential confounders/modifiers during the medical examinations. Cox proportional hazard regression was applied to calculate hazard ratios (HRs).
During the follow-up, 4,046 incident CKD cases were identified, and the incidence rate was 6.24 per 1,000 person-years. In contrast with participants with the first quintile exposure of , participants with the fourth and fifth quintiles exposure of had increased risk of CKD development, adjusting for age, sex, educational level, smoking, drinking, body mass index, systolic blood pressure, fasting glucose, total cholesterol, and self-reported heart disease or stroke, with an HR [95% confidence interval (CI)] of 1.11 (1.02, 1.22) and 1.15 (1.05, 1.26), respectively. A significant concentration–response trend was observed ( ). Every increment in the concentration was associated with a 6% higher risk of developing CKD (HR: 1.06, 95% CI: 1.02, 1.10). Sensitivity and stratified analyses yielded similar results.
Long-term exposure to ambient was associated with an increased risk of CKD development. Our findings reinforce the urgency to develop global strategies of air pollution reduction to prevent CKD. https://doi.org/10.1289/EHP3304