Abstract
BackgroundAmbient 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 DiscussionStudies 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 ConclusionThe 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.RegistrationThe systematic review protocol was submitted and published by the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020175615).
Highlights
Ambient fine particulate matter (PM < 2.5 μm, PM2.5) is gaining increasing attention as an environmental risk factor for health
From the total of excluded records, 32 articles were not written in English, 140 articles did not focus on ambient PM2.5specifically, and 146 did not address the kidney or kidney disease outcomes
These results suggest that P M2.5 exposure has acute effects on the occurrence of anti-dsDNA and urinary casts; as the kinetics of anti-dsDNA and urinary casts are not entirely understood, it is physiologically plausible that these markers vary daily with fluctuating PM2.5 exposure
Summary
Ambient fine particulate matter (PM < 2.5 μm, PM2.5) is gaining increasing attention as an environmental risk factor for health. Altered kidney function may affect homeostasis and, Rasking et al Environmental Health (2022) 21:24 subsequently, lead to dysfunctions in other tissues [2, 3]. Saenen et al [14] showed the presence of black carbon particles – a significant component of PM2.5 – as a marker of medium-term to chronic exposure to combustion-related air pollution in the urine of healthy individuals. The presence of these toxic particles may cause direct or indirect adverse effects on the kidneys. Persons already diagnosed with a disease affecting the kidney (e.g., diabetes mellitus) or with a compromised immune system (e.g., kidney transplant recipients) could experience a worsening of symptoms following increased P M2.5 exposure [16]
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