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Association of air pollution with incidence of end-stage kidney disease in two large European cohorts.
- Source :
-
The Science of the total environment [Sci Total Environ] 2024 Oct 20; Vol. 948, pp. 174796. Date of Electronic Publication: 2024 Jul 18. - Publication Year :
- 2024
-
Abstract
- End-stage kidney disease (ESKD) poses a high burden on patients and health systems. While numerous studies indicate an association between air pollution and chronic kidney disease, studies on ESKD are rare. We investigated the association of long-term exposure to nitrogen dioxide (NO₂), fine particulate matter (PM <subscript>2.5</subscript> ), black carbon (BC) and ozone (O <subscript>3</subscript> ) with ESKD incidence in two large population-based European cohorts. We followed individuals in the Austrian Vorarlberg Health Monitoring and Promotion Program (VHM&PP) and the Italian Rome Longitudinal Study (RoLS) using dialysis and kidney transplant registries. Long-term exposure to pollutants was estimated at the home address using Europe-wide land use regression models at 100x100m scale. Hazard ratios (HR) were determined from Cox-proportional hazard models adjusted for individual and neighbourhood level confounders. We observed 501 events among 136,823 individuals in VHM&PP (mean age 42.1 years; crude incidence rate (IR) 0.14 per 1000 person-years) and 3231 events among 1,939,461 individuals in RoLS (mean age 52.4 years; IR 0.22 per 1000 person-years). In VHM&PP, there was no evidence of an association between PM <subscript>2.5</subscript> or O <subscript>3</subscript> and ESKD. There were elevated HRs but with large confidence intervals for BC (HR 1.17 [95 % confidence interval (CI): 0.98, 1.39] for 0.5*10 <superscript>-5</superscript> /m), and for NO₂ (HR 1.14 [95%CI: 0.96, 1.35] for 10 μg/m <superscript>3</superscript> ). In RoLS, ESKD was associated with PM <subscript>2.5</subscript> (HR 1.37 [95 % CI: 1.06, 1.76] for an increase of 5 μg/m <superscript>3</superscript> ), while there was no evidence of association with BC, NO <subscript>2</subscript> , or O <subscript>3</subscript> exposure. Our study suggests an association of air pollution with ESKD incidence, which differed between the two cohorts and may possibly be influenced by respective air pollution mixtures.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Incidence
Male
Middle Aged
Female
Adult
Environmental Exposure statistics & numerical data
Nitrogen Dioxide analysis
Ozone analysis
Cohort Studies
Italy epidemiology
Europe epidemiology
Longitudinal Studies
Kidney Failure, Chronic epidemiology
Air Pollution statistics & numerical data
Particulate Matter analysis
Air Pollutants analysis
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1026
- Volume :
- 948
- Database :
- MEDLINE
- Journal :
- The Science of the total environment
- Publication Type :
- Academic Journal
- Accession number :
- 39032743
- Full Text :
- https://doi.org/10.1016/j.scitotenv.2024.174796