Long-Term Exposure to Ambient PM2.5 and Increased Risk of CKD Prevalence in China

Background Fine particulate matter (PM 2.5 ) is an important environmental risk factor for cardiopulmonary diseases. However, the association between PM 2.5 and risk of CKD remains under-recognized, especially in regions with high levels of PM 2.5 , such as China. Methods To explore the association between long-term exposure to ambient PM 2.5 and CKD prevalence in China, we used data from the China National Survey of CKD, which included a representative sample of 47,204 adults. We estimated annual exposure to PM 2.5 before the survey date at each participant’s address, using a validated, satellite-based, spatiotemporal model with a 10 km×10 km resolution. Participants with eGFR <60 ml/min per 1.73 m 2 or albuminuria were defined as having CKD. We used a logistic regression model to estimate the association and analyzed the influence of potential modifiers. Results The 2-year mean PM 2.5 concentration was 57.4 μ g/m 3 , with a range from 31.3 to 87.5 μ g/m 3 . An increase of 10 μ g/m 3 in PM 2.5 was positively associated with CKD prevalence (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.22 to 1.35) and albuminuria (OR, 1.39; 95% CI, 1.32 to 1.47). Effect modification indicated these associations were significantly stronger in urban areas compared with rural areas, in males compared with females, in participants aged <65 years compared with participants aged ≥65 years, and in participants without comorbid diseases compared with those with comorbidities. Conclusions These findings regarding the relationship between long-term exposure to high ambient PM 2.5 levels and CKD in the general Chinese population provide important evidence for policy makers and public health practices to reduce the CKD risk posed by this pollutant.