Effect of ambient air pollution exposure on renal dysfunction among hospitalized patients in Shanghai, China

Wang, W.; Wu, Chuanlong; Mu, Zhanglei; Gu, Yongzhe; Zheng, Yongtao; Ren, Longbing; Hu, Yang; Liang, Ajuan; P, Li; Zhang, L.; Li, J.

doi:10.1016/j.puhe.2020.01.001

Cited by 21 publications

(23 citation statements)

References 35 publications

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“…A higher risk for CKD prevalence was demonstrated for PM 2.5 and PM 2.5 absorbance; the risk of CKD progression was elevated for PM 2.5 absorbance. Wang et al (2020) [ 41 ] (cross-sectional study) The mean ± SD PM 2.5 exposure level was 61.22 ± 0.50 µg/m³, far exceeding the WHO air quality guidelines. Hospitalized Chinese patients with a mean ± SD age of 60.37 ± 14.48 years (n = 3,622).…”

Section: Resultsmentioning

confidence: 99%

“…It is of note that not all studies use the same equation to determine eGFR. Of all studies addressing measurement(s) of eGFR in this review, 5 studies [ 21 , 43 , 46 – 48 ] estimated GFR according to the MDRD equation, one study [ 51 ] did not specify, and one study [ 24 ] used both equations to estimate GFR, while 13 studies [ 22 , 23 , 25 – 27 , 29 , 34 , 37 , 38 , 41 , 42 , 44 , 49 ] used the CKD-EPI equation to determine eGFR. Current research is contradictory about the superiority of either methods to estimate GFR [ 38 , 62 , 65 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cross-sectional studies conducted by Wang et al [ 41 ] and Yang et al [ 42 ] demonstrated the lack of significant associations between PM 2.5 exposure and lower eGFR as an indication of CKD development (β = 0.10, 95% CI -0.30 – 0.49 [ 41 ] and β = -0.09, 95% CI -0.25 to 0.07 [ 42 ], respectively) as well as increased CKD prevalence (OR = 0.99, 95% CI 0.91 to 1.08 [ 41 ] and OR = 1.03, 95% CI 0.97 to 1.09 [ 42 ], respectively). However, Wang et al [ 41 ] stipulated that not all crucial confounders were estimated and taken into account in the statistical model(s), which might also be a limitation in the study conducted by Yang and colleagues [ 42 ]. Another cross-sectional study, investigating an elderly population (≥ 65 years of age) with stage III to V of CKD, could not show any associations between eGFR as a measure for CKD development or progression and a 4.1 µg/m³ IQR increment of PM 2.5 exposure [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…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. 2) [56][57][58][59].…”

Section: Study Characteristicsmentioning

confidence: 99%

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

et al. 2022

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Background Ambient fine particulate matter (PM < 2.5 μm, PM2.5) is gaining increasing attention as an environmental risk factor for health. The kidneys are considered a particularly vulnerable target to the toxic effects that PM2.5 exerts. Alteration of kidney function may lead to a disrupted homeostasis, affecting disparate tissues in the body. This review intends to summarize all relevant knowledge published between January 2000 and December 2021 on the effects of ambient PM2.5 and the adverse effects on kidney function in adults (≥ 18 years). Results and Discussion Studies published in peer-reviewed journals, written in English, regarding the effects of PM2.5 on kidney function and the development and/or exacerbation of kidney disease(s) were included. Of the 587 nonduplicate studies evaluated, 40 were included, comprising of studies on healthy or diagnosed with pre-existing disease (sub)populations. Most of the studies were cohort studies (n = 27), followed by 10 cross-sectional, 1 ecological and 2 time-series studies. One longitudinal study was considered intermediate risk of bias, the other included studies were considered low risk of bias. A large portion of the studies (n = 36) showed that PM2.5 exposure worsened kidney outcome(s) investigated; however, some studies show contradictory results. Measurement of the estimated glomerular filtration rate, for instance, was found to be positively associated (n = 8) as well as negatively associated (n = 4) with PM2.5. Limitations and Conclusion The main limitations of the included studies include residual confounding (e.g., smoking) and lack of individual exposure levels. The majority of included studies focused on specific subpopulations, which may limit generalizability. Evidence of the detrimental effects that ambient PM2.5 may exert on kidney function is emerging. However, further investigations are required to determine how and to what extent air pollution, specifically PM2.5, exerts adverse effects on the kidney and alters its function. Registration The systematic review protocol was submitted and published by the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020175615).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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

et al. 2022

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“…44 45 Air pollution was reportedly associated with lower eGFR and increased prevalence of CKD, thus increasing the risk of HUA. 46 Furthermore, previous studies have confirmed that air pollution contained toxic organic agents, including polychlorinated biphenyls, polycyclic aromatic hydrocarbons, perfluorinated alkyl substances and dioxins, which can increase SUA concentrations and the incidence of HUA. 47 Exposure to greater concentrations of long-term ambient air pollutants has been confirmed to be associated with a higher incidence of HUA.…”

Section: Discussionmentioning

confidence: 95%

Association between urbanisation and the risk of hyperuricaemia among Chinese adults: a cross-sectional study from the China Health and Nutrition Survey (CHNS)

Zhu

Zhang

et al. 2021

BMJ Open

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ObjectiveTo explore the association between urbanicity and hyperuricaemia (HUA) and whether urbanicity is an independent risk factor for HUA in Chinese adults.DesignData analysis from a cross-sectional survey.Setting and participants8579 subjects aged 18 years or older were enrolled in the study from the 2009 wave of the China Health and Nutrition Survey to analyse the association between urbanicity and HUA. We divided them into three categories according to urbanisation index (low, medium and highly urbanised groups).Main outcome measuresHUA was defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women.ResultsThe prevalence of HUA in low, medium and highly urbanised groups was 12.2%, 14.6% and 19.8%, respectively. The independent factors influencing serum uric acid included age, gender, hypertension, diabetes, chronic kidney disease, drinking, obesity and community-level urbanisation index (β=0.016, p<0.001). The risk of HUA in the highly urbanised group was significantly higher than that of the low urbanised group (OR 1.771, 95% CI 1.545 to 2.029, p<0.001), even after adjusting for other covariates (OR 1.661, 95% CI 1.246 to 2.212, p=0.001). In a subgroup analysis, we found that age, gender, comorbidity (such as hypertension, diabetes, obesity and chronic kidney disease) and physical activity affected the association between urbanisation and the risk of HUA.ConclusionsOur findings suggest that living in highly urbanised areas is linked with higher risk of HUA independent of cardiometabolic and health-related behavioural risk factors, which have been shown to increase along with urbanisation.

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Association of air pollution and risk of chronic kidney disease: A systematic review and meta‐analysis

Xu,

Jia,

Lin

et al. 2023

J Biochem & Molecular Tox

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Although epidemiological studies have evaluated the association between ambient air pollution and chronic kidney disease (CKD), the results remain mixed. To clarify the nature of the association, we conducted a comprehensive systematic review and meta‐analysis to assess the global relationship between air pollution and CKD. The Web of Science, PubMed, Embase and Cochrane Library databases systematically were searched for studies published up to July 2023 and included 32 studies that met specific criteria. The random effects model was used to derive overall risk estimates for each pollutant. The meta‐analysis estimated odds ratio (ORs) of risk for CKD were 1.42 (95% confidence interval [CI]: 1.31–1.54) for each 10 μg/m3 increase in PM2.5; 1.20 (95% CI: 1.14–1.26) for each 10 μg/m3 increase in PM10; 1.07 (95% CI: 1.05–1.09) for each 10 μg/m3 increase in NO2; 1.03 (95% CI: 1.02–1.03) for each 10 μg/m3 increase in NOX; 1.07 (95% CI: 1.01–1.12) for each 1 ppb increase in SO2; 1.03 (95% CI: 1.00–1.05) for each 0.1 ppm increase in CO. Subgroup analysis showed that this effect varied by gender ratio, age, study design, exposure assessment method, and income level. Furthermore, PM2.5, PM10, and NO2 had negative effects on CKD even within the World Health Organization‐recommended acceptable concentrations. Our results further confirmed the adverse effect of air pollution on the risk of CKD. These findings can contribute to enhance the awareness of the importance of reducing air pollution among public health officials and policymakers.

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Effect of ambient air pollution exposure on renal dysfunction among hospitalized patients in Shanghai, China

Cited by 21 publications

References 35 publications

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

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

Association between urbanisation and the risk of hyperuricaemia among Chinese adults: a cross-sectional study from the China Health and Nutrition Survey (CHNS)

Association of air pollution and risk of chronic kidney disease: A systematic review and meta‐analysis

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