Clinical outcomes associated with long-term exposure to airborne particulate pollution in kidney transplant recipients

Abstract

We aimed to evaluate the relationship of 10-μm particulate matter (PM10) with the risk of graft failure, mortality, and decline of graft function in kidney transplant recipients (KTRs). Air pollutant data were obtained from the Korean National Institute of Environmental Research and linked to those of 1,532 KTRs who underwent kidney transplantation in tertiary hospital from 2001 to 2015. Survival models were used to evaluate the association of PM10 concentrations and the risk of death-censored graft failure (DCGF), all-cause mortality, and biopsy-proven rejection (BPR) over a median follow-up of 6.31 years. The annual average PM10 exposure after KT was 27.1 ± 8.0 μg/m3. Based on the 5-year baseline exposure, a 1-μg/m3 increase in PM10 concentration was associated with increased risk of DCGF and BPR. All-cause mortality was significantly associated with 5-year average PM10 concentrations before the event in fully adjusted models. Long-term PM10 exposure has a significant association with respect to the risk of BPR, DCGF, and all-cause mortality.