Associations of ambient coarse particulate matter, nitrogen dioxide, and carbon monoxide with the risk of kidney disease: a cohort study

作者：Benjamin Bowe, Yan Xie, Tingting Li, Yan Yan, Hong Xian, Ziyad Al‐Aly · 发表于：The Lancet Planetary Health · 年份：2017 · DOI：10.1016/s2542-5196(17)30117-1 · 被引用次数：200 · 研究领域：Heme Oxygenase-1 and Carbon Monoxide、Air Quality and Health Impacts、High Altitude and Hypoxia

Background Experimental evidence and preliminary clinical evidence suggest that environmental air pollution adversely effects kidney health. Previous work has examined the association between fine particulate matter and risk of kidney disease; however, the association between ambient coarse particulate matter (PM 10 ; ≤10 μm in aerodynamic diameter), nitrogen dioxide (NO 2 ), and carbon monoxide (CO) and risk of incident chronic kidney disease, chronic kidney disease progression, and end-stage renal disease is not clear. Methods We merged multiple large databases, including those of the Environmental Protection Agency and the Department of Veterans Affairs, to build a cohort of US veterans, and used survival models to evaluate the association between PM 10 , NO 2 , and CO concentrations and risk of incident estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1·73 m 2 , incident chronic kidney disease, eGFR decline of 30% or more, and end-stage renal disease. We treated exposure as time-varying when it was updated annually and as cohort participants moved. Findings Between Oct 1, 2003, and Sept 30, 2012, 2 010 398 cohort participants were followed up over a median of 8·52 years (IQR 8·05–8·80). An increased risk of eGFR of less than 60 mL/min per 1·73 m 2 was associated with an IQR increase in concentrations of PM 10 (hazard ratio 1·07, 95% CI 1·06–1·08), NO 2 (1·09, 1·08–1·10), and CO (1·09, 1·08–1·10). An increased risk of incident chronic kidney disease w...