Journal
SCIENCE OF THE TOTAL ENVIRONMENT
Volume 706, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.scitotenv.2019.135522
Keywords
Air pollutants; Chronic kidney disease; Meta-analysis; Particulate matter; Estimated glomerular filtration rate; Albumin creatinine ratio
Categories
Funding
- Taipei Medical University [TMU105-AEI-B33]
- Shuang Ho Hospital [W106HCP-01-1-3]
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Background: The association between incident chronic kidney disease (CKD) Of 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-eftects 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, O-3) 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 mu g/m(3) increase in PM2.5 and 1.16 (95% CI 1.05, 1.29; derived from four studies) for PM10; 131 (95% CI 0.36, 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 to and PM2.5 (of 10 mu g/m(2)) 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 m(2), respectively. Conclusions: Air pollution was observed to be associated with CKD and renal function clecline. Although more longitudinal studies are required, we argue that air pollution is pernicious to kidney health. (C) 2019 Elsevier B.V. All rights reserved.
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