Long-term exposure to ambient air pollution and renal function in African Americans: the Jackson Heart Study

Abstract

Renal dysfunction is prevalent in the US among African Americans. Air pollution is associated with renal dysfunction in mostly white American populations, but not among African Americans. We evaluated cross-sectional associations between 1-year and 3-year fine particulate matter (PM 2.5 ) and ozone (O 3 ) concentrations and renal function among 5090 African American participants in the Jackson Heart Study. We used mixed-effect linear regression to estimate associations between 1-year and 3-year PM 2.5 and O 3 and estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio (UACR), serum creatinine, and serum cystatin C, adjusting for: sociodemographic factors, health behaviors, and medical history and accounting for clustering by census tract. At baseline, JHS participants had mean age 55.4 years, and 63.8% were female; mean 1-year and 3-year PM 2.5 concentrations were 12.2 and 12.4 μg/m 3 , and mean 1-year and 3-year O 3 concentrations were 40.2 and 40.7 ppb, respectively. Approximately 6.5% of participants had reduced eGFR (<60 mL/min/1.73m 2 ) and 12.7% had elevated UACR (>30 μg/g), both indicating impaired renal function. Annual and 3-year O 3 concentrations were inversely associated with eGFR and positively associated with serum creatinine; annual and 3year PM 2.5 concentrations were inversely associated with UACR. We observed impaired renal function associated with increased O 3 but not PM 2.5 exposure among African Americans.

The global and national burden of chronic kidney disease attributable to ambient fine particulate matter air pollution: a modelling study

“…We integrated all available evidence to build and characterise a non-linear exposure–response model of the relationship between PM 2.5 and risk of CKD; a flow chart of data curation and description of included studies are available in supplementary figure S1 and table 1 1 2 50–57. For potential inclusion in the meta-regression analyses, we identified six studies on PM 2.5 , one study on secondhand smoke, and three studies on active smoking (online supplementary figure S1 and table 1), leading to a total of 30 data points, 15 of which were from PM 2.5 studies.…”

Association of PM 2.5 Reduction with Improved Kidney Function: A Nationwide Quasiexperiment among Chinese Adults

“…Specifically, a cohort study based on 669 US male veterans observed that a 2.1 μg/m 3 IQR higher 1-year PM 2.5 was significantly associated with decreased change in eGFR of -1.87 (-2.99, -0.76) mL/min/1.73 m 2 , (12) while another cross-sectional study based on 21,656 Taiwanese concluded an insignificant association (7). To be noted, three other studies have also investigated the similar hypothesis but were not included in the meta-analysis (8,10,11). Two cross-sectional studies in African Americans and Taipei city residents reported insignificant associations (8,11), while another nationwide cohort study among 2,482,737 US veterans found that a 10 μg/m 3 increase in PM 2.5 concentration was associated with significant increased risk of Longitudinal covariates denoted temporal changes in the inconstant variables (i.e., body weight, marriage, drinking, smoking, cooking energy type, and indoor temperature maintenance); the baseline covariates denoted values of the longitudinal variables in the baseline wave and the constant variables (i.e., residence, sex, education, age at 2011, and average BMI).…”

“…To be noted, three other studies have also investigated the similar hypothesis but were not included in the meta-analysis (8,10,11). Two cross-sectional studies in African Americans and Taipei city residents reported insignificant associations (8,11), while another nationwide cohort study among 2,482,737 US veterans found that a 10 μg/m 3 increase in PM 2.5 concentration was associated with significant increased risk of Longitudinal covariates denoted temporal changes in the inconstant variables (i.e., body weight, marriage, drinking, smoking, cooking energy type, and indoor temperature maintenance); the baseline covariates denoted values of the longitudinal variables in the baseline wave and the constant variables (i.e., residence, sex, education, age at 2011, and average BMI). Along x-axis, the positive/negative change means increase/decrease in a biomarker.…”

“…Increasing evidence from human studies has revealed associations between air pollution and declining kidney function indicators such as the prevalence (7)(8)(9), incident and progression of CKD (8,10), and decreased estimated glomerular filtration rates (eGFR) (7,8,(11)(12)(13); although, the findings remain inconsistent. A study which included 1.1 million adults from the US Medicare program reported that the annual concentration of county-level PM 2.5 was positively associated with the prevalence of diagnosed CKD (9).…”

Phytoremediation: The Sustainable Strategy for Improving Indoor and Outdoor Air Quality

“…They demonstrated that an increase of 10 µg/m 3 PM 2.5 was associated with a 24% increase in the cardiovascular disease incident and a 76% increase in cardiovascular disease-related death [37]. Other studies that revealed a significant correlation between PM exposure and other human diseases are summarized in Table 1 [38][39][40][41].…”