BACKGROUND AND AIM: The incidence and prevalence of CKD are increasing worldwide. Recent epidemiological studies have shown that air pollution also contributes the renal health, however few studies have demonstrated the differential effects of different types of air pollutants on renal function. In this study, we evaluated the association between air pollution exposure, deterioration of kidney function and CKD prevalence using the 7th Korean National Health and Nutrition Examination Survey (KNHANES) data. METHODS: The KNHANES data (2016–2018) were used to estimate estimated glomerular filtration rate (eGFR) by the CKD–EPI equation and the CKD was defined as an eGFR of 60 mL/min/1.73 m2. Air pollutants (PM2.5, PM10, SO2, NO2, CO, and O3) were obtained from the AirKorea. Given the characteristic of this data (stratified, multistage, and cluster sampling design), all analyses were performed in a complex survey design. We conducted multivariate linear regression and logistic regression analysis to assess the association between air pollution exposure and kidney function after adjusting the covariates including gender, body mass index, education level, household income, smoking status, frequency of drinking, underling diseases, and serum triglyceride. RESULTS:A total of 15,308 adults aged 20 or older were included in the analyses. The exposure to PM2.5, PM10, NO2 and CO was associated with lower eGFR (PM2.5: -4.67, 95% CI: -6.16, -3.18; PM10: -2.19, 95% CI: -2.84, -1.54; NO2: -1.56, 95% CI: -2.16, -0.97; CO: -1.34, 95% CI: -1.96, -0.71). The prevalence of CKD was related to PM2.5 (OR: 1.97, 95% CI: 1.14, 3.42) and PM10 (OR: 1.45, 95% CI: 1.10, 1.91). association. CONCLUSIONS:Annual exposure to PM2.5, PM10, NO2, and CO was associated with a higher risk of lower eGFR and prevalent CKD. A significant exposure-response association was observed between PM2.5, PM10, and CO exposure and low eGFR. KEYWORDS: Air pollution, Chronic kidney disease, Glomerular filtration rate, Republic of Korea