Association between air pollutants and development of chronic kidney disease: A systematic review and meta-analysis
Journal
Science of the Total Environment
Journal Volume
706
Date Issued
2020
Author(s)
Abstract
Background: The association between incident chronic kidney disease (CKD) or end-stage renal disease (ESRD) and exposure to outdoor air pollution is under debate. We aimed to examine this relationship based on a systematic review with random-effects meta-analysis. Methods: We screened the literature on long-term air pollution exposure assessment in the general population using an electronic search of PubMed, Medline, Embase, and Cochrane Library from inception to 20 October 2019. Observational studies investigating the association between long-term exposure to gaseous (CO, SO2, NO2, O3) or particulate (PM2.5 or PM10) outdoor air pollutants and CKD, ESRD, or renal dysfunction were included, and summary risks were estimated. Results: Of 4419 identified articles, 23 met our inclusion criteria after screening and 14 were included in the meta-analysis. Pooled effect estimates had the following summary risk ratios (RRs) for CKD: 1.10 (95% confidence intervals [CI] 1.00, 1.21; derived from four studies) per 10 μg/m3 increase in PM2.5 and 1.16 (95% CI 1.05, 1.29; derived from four studies) for PM10; 1.31 (95% CI 0.86, 2.00; derived from two studies) per 10 ppm increase in CO; and 1.11 (95% CI 1.09, 1.14; derived from three studies) per 10 ppb increase in NO2. For the pooled effect on eGFR, increases in PM10 and PM2.5 (of 10 μg/m3) were associated with eGFR decline by ?0.83 (95% CI –1.54, ?0.12; derived from two studies) and ?4.11 (95% CI –12.64, 4.42; derived from two studies) mL/min/1.73 m2, respectively. Conclusions: Air pollution was observed to be associated with CKD and renal function decline. Although more longitudinal studies are required, we argue that air pollution is pernicious to kidney health. ? 2019 Elsevier B.V.
SDGs
Other Subjects
Diagnosis; Digital libraries; Nitrogen oxides; Particles (particulate matter); Random processes; Risk perception; Air pollutants; Albumin creatinine ratio; Chronic kidney disease; Glomerular filtration rate; Meta analysis; Particulate Matter; Air pollution; carbon monoxide; nitrogen dioxide; sulfur dioxide; atmospheric pollution; disease; health risk; literature review; meta-analysis; particulate matter; pollution exposure; air pollution; Article; chronic kidney failure; end stage renal disease; estimated glomerular filtration rate; global disease burden; human; long term exposure; membranous glomerulonephritis; nephrotic syndrome; particulate matter; priority journal; proteinuria; systematic review; air pollutant; air pollution; environmental exposure; longitudinal study; meta analysis; odds ratio; Air Pollutants; Air Pollution; Environmental Exposure; Humans; Kidney Failure, Chronic; Longitudinal Studies; Odds Ratio; Particulate Matter
Publisher
Elsevier B.V.
Type
journal article