Air pollution and the risk of incident chronic kidney disease in patients with diabetes: An exposure-response analysis

Feifei Zhang; Chao Yang; Fulin Wang; Yuhao Liu; Chuan-Guo Guo; Pengfei Li; Luxia Zhang

Ecotoxicology and Environmental Safety (Jan 2024)

Air pollution and the risk of incident chronic kidney disease in patients with diabetes: An exposure-response analysis

Feifei Zhang,
Chao Yang,
Fulin Wang,
Yuhao Liu,
Chuan-Guo Guo,
Pengfei Li,
Luxia Zhang

Affiliations

Feifei Zhang: National Institute of Health Data Science at Peking University, Peking University Health Science Center, Beijing 100191, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing 100191, China
Chao Yang: Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
Fulin Wang: National Institute of Health Data Science at Peking University, Peking University Health Science Center, Beijing 100191, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing 100191, China
Yuhao Liu: Peking University Health Science Center, Beijing 100191, China
Chuan-Guo Guo: Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Pengfei Li: Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
Luxia Zhang: National Institute of Health Data Science at Peking University, Peking University Health Science Center, Beijing 100191, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing 100191, China; Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; Correspondence to: National Institute of Health Data Science at Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.

Journal volume & issue: Vol. 270
p. 115829

Abstract

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Impact of air pollution on incident chronic kidney disease (CKD) in diabetic patients is insufficiently studied. We aimed to examine exposure-response associations of PM2.5, PM10, PM2.5–10, NO2, and NOX with incident CKD in diabetic patients in the UK. We also widened exposure level of PM2.5 and examined PM2.5-CKD association in diabetic patients across the entire range of global concentration. Based on data from UK biobank cohort, we applied Cox proportional hazards models and the shape constrained health impact function to investigate the associations between air pollutants and incident CKD in diabetic patients. Global exposure mortality model was applied to combine the PM2.5-CKD association in diabetic patients in the UK with all other published associations. Multiple air pollutants were positively associated with incident CKD in diabetic patients in the UK, with hazard ratios (HRs) of 1.034 (95 %CI: 1.015–1.053) and 1.021 (95 %CI: 1.007–1.036) for every 1 μg/m3 increase in PM2.5 and PM10 concentration, and 1.113 (95 %CI: 1.053–1.177) and 1.058 (95 %CI: 1.027–1.091) for every 10 μg/m3 increase in NO2 and NOX concentration, respectively. For PM2.5–10, associations with CKD in diabetic patients did not reach the statistical significance. Exposure-response associations with CKD in diabetic patients showed a near-linear trend for PM2.5, PM10, NO2, and NOX in the UK, whereas PM2.5-DKD associations in the globe exhibited a non-linear increasing trend. This study supports that air pollution could significantly increase the risk of CKD onset in diabetic patients.

Published in Ecotoxicology and Environmental Safety

ISSN: 0147-6513 (Print); 1090-2414 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Technology: Environmental technology. Sanitary engineering: Environmental pollution; Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/ecotoxicology-and-environmental-safety

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