Associations between Personal PM_2.5 Elemental Constituents and Decline of Kidney Function in Older Individuals: the China BAPE Study

Abstract

Long-term exposure to fine particulate matter (PM 2.5 ) is associated with kidney dysfunction. However, few studies have investigated acute effects of PM 2.5 elemental constituents on renal function. We evaluated associations between personal PM 2.5 and its elemental constituents and kidney function, assessed by an estimated glomerular filtration rate (eGFR) in Biomarkers of Air Pollutants Exposure in the Chinese aged 60−69 study. Seventy one older individuals were visited monthly between September 2018 and January 2019. Each participant wore a PM 2.5 monitor for 72 h, responded to a questionnaire, and underwent a physical examination with blood sampling. Linear mixed-effect models were used to estimate associations between personal PM 2.5 elemental constituents and eGFR. We found that significant changes in eGFR from −1.69% [95% confidence interval (CI): −3.34%, −0.01%] to −3.27% (95% CI: −5.04%, −1.47%) were associated with interquartile range (IQR) increases in individual PM 2.5 exposures at various lag periods (7−12, 13−24, 0−24, 25−48, and 49−72 h). An IQR increase in 72 h moving averages of copper, manganese, and titanium in personal PM 2.5 corresponded to −2.34% (95% CI: −3.67%, −0.99%) to −4.56% (95% CI: −7.04%, −2.00%) changes in eGFR. Personal PM 2.5 and some of its elemental constituents are inversely associated with eGFR in older individuals.

Adverse Effects of fine particulate matter on human kidney functioning: a systematic review

“…In addition, in a general adult Taiwanese population (n = 108,615) with an average ± SD age of 39.1 ± 11.8 years, Zeng et al [47] demonstrated that each 10 µg/m³ increment of PM 2.5 could be significantly associated (p < 0.001) with a 3.18-fold increased risk of an eGFR decline ≥30% (95% CI 2.88 to 3.50). In an elderly population (60 -69 years old; n = 71), the panel study of Fang et al [21] showed that an IQR increment of 31.43 µg/m³ in PM 2.5 exposure was significantly associated (p < 0.05) with a 3.27% eGFR decrease, albeit in a small population size (n = 71).…”

“…The risk of bias analysis was performed using the Newcastle -Ottowa Scale and articles were ranked accordingly: gaining ≤ 3 stars meant a high risk of bias, ≤ 5 stars an intermediate risk of bias, and ≥ 6 stars a low risk of bias [20]. One article had an intermediate risk of bias [21], while no articles were considered as high risk of bias (Supplementary Table 1).…”

“…The 40 studies included in this systematic review were either cohort studies (n = 27, Table 1), cross-sectional (n = 10, Table 2), ecological (n = 1, Table 3), or a time-series study (n = 2, Table 3) and conducted in an epidemiological context of exposure to ambient PM 2.5 . We identified studies investigating (i) clinical measurements of the estimated glomerular filtration rate (eGFR) (n = 8) [15,[21][22][23][24][25][26][27], (ii) general kidney functioning through changes in biomarkers (n = 2) [28,29], and (iii) glomerular diseases (n = 4) [30][31][32], including systemic lupus erythematosus (SLE; n = 1) [33]. The remaining 26 articles focused on persons with a diagnosis of diabetes mellitus (n = 2) [34,35], the development and/or worsening of CKD (n = 14) [36][37][38][39][40][41][42][43][44][45][46][47][48][49], ESRD (n = 2) [50,51], renal failure (n = 4) [52][53][54][55], and kidney transplant outcome (n = 4) (Fig.…”

“…According to the new air quality guidelines announced in 2021, all studies exceeded the newly set guidelines for the annual mean (5 µg/m³) or the 24-hour mean (15 µg/m³) [10]. Additionally, 8 studies listed average PM 2.5 exposure levels divergent from annual or daily means [15, 21, 24, 28-30, 32, 35, 46], i.e., 72-hour PM 2.5 exposure means [21], various moving day averages [24] two-year [46], three-year [30] or seven-year [50] annual PM 2.5 means, PM 2.5 means during the study or follow-up period [32,35], and means of PM 2.5 exposure during the pregnancy [15]. Furthermore, 27 of the 40 included studies showed significant results or associations with investigated parameters and PM 2.5 exposure [15, 21, 23, 26, 30-32, 34-37, 39, 40, 43-54, 58, 59]; 4 studies did not show any significant results or associations [24,25,42,56].…”

Short-term exposure to fine particulate air pollution and emergency department visits for kidney diseases in the Atlanta metropolitan area

“…For example, a panel study with 76 participants 60–69 years of age in Jinan, China observed that significant declines in eGFR from −1.69% (95% CI: −3.34%, −0.01%) to −3.27% (95% CI: −5.04%, −1.47%) were associated with IQR increases in personal PM 2.5 exposures at different lag periods (from 7–12 to 49–72 hours). 20 Another panel study with 105 children 4–13 years of age in Wuhan, China, showed that personal exposure to PM 2.5 was dose-responsive related to decline in eGFR within lag 2 days with the strongest at lag 0 day [−1.69% (95% CI: −2.27%, −1.10%) in eGFR per 10 μg/m 3 increase in PM 2.5 ]. 22 Gu et al 21 and Wei et al 23 reported that short-term (daily) PM 2.5 exposure was associated with increased risks of hospital admission for kidney diseases based on electronic inpatient records in China (all-age) and the United States (age 65 years or older), respectively.…”