Particulate matter, albumin/creatinine ratio, and chronic kidney disease in a prospective cohort study

Abstract

Background: Many studies have investigated the association between exposure to particulate matter (PM) and kidney dysfunction, but the relationship is inconsistent due to the variations in exposure assessment, the use of renal-function indices, and study design. Objectives: This study elucidated the associations between exposure to PM10, PM2.5, and PM1 with albumin/creatinine ratio (ACR) and the incidence of chronic kidney disease (CKD) in a community-based cohort in Taiwan. Methods: A total of 704 residents living in Taichung were recruited as study subjects at the baseline of 2004 and followed up to the end of 2018. Questionnaire and health examination was used to collect personal information and renal-function indices at baseline and follow-up. Land-use regression models were established to predict individual levels of PM10, PM2.5, and PM1 annually during studying periods. The multivariable linear regression and Cox regression were conducted to investigate the associations between PM exposures, ACR, and the incident CKD (creatinine-based estimated glomerular filtration rate, [eGFRcr] < 60ml/min/1.73m2). Results: We found that an increase of 1 µg/m3 in PM10, PM2.5, and PM1 was associated with the decreased ACR of 1.10±1.14 mg/g (p=0.080), 4.66±2.17 mg/g (p=0.032), and 6.05±2.82 mg/g (p=0.032), respectively. The similar associations were identified for the cumulative exposure of 1 µg/m3-year to PM10, PM2.5, and PM1, which decreased the ACR of 0.14±0.10 mg/g (p=0.157), 0.55±0.27 mg/g (p=0.040), and 0.72±0.35 mg/g (p=0.040), respectively. Per 1 µg/m3 increase in PM10, PM2.5, and PM1 was associated with the elevated risk of 1.07-fold (95% confidence interval [CI]=1.00-1.15, p=0.055), 1.19-fold (95% CI=1.04-1.37, p=0.011), and 1.26-fold (95% CI=1.05-1.50, p=0.011) in the incident CKD, respectively. Conclusions: The present study showed that exposure to PM2.5 and PM1 was associated with the decreased renal function to increase the risk of developing CKD.