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Long-term ambient air pollution exposure and renal function and biomarkers of renal disease

Kilbo Edlund, Karl ; Xu, Yiyi LU ; Andersson, Eva M. ; Christensson, Anders LU ; Dehlin, Mats ; Forsblad-d’Elia, Helena ; Harari, Florencia ; Ljunggren, Stefan ; Molnár, Peter and Oudin, Anna LU , et al. (2024) In Environmental Health: A Global Access Science Source 23(1).
Abstract

Background: Despite accumulating evidence of an association between air pollution and renal disease, studies on the association between long-term exposure to air pollution and renal function are still contradictory. This study aimed to investigate this association in a large population with relatively low exposure and with improved estimation of renal function as well as renal injury biomarkers. Methods: We performed a cross-sectional analysis in the middle-aged general population participating in the Swedish CardioPulmonary bioImaging Study (SCAPIS; n = 30 154). Individual 10-year exposure to total and locally emitted fine particulate matter (PM2.5), inhalable particulate matter (PM10), and nitrogen oxides... (More)

Background: Despite accumulating evidence of an association between air pollution and renal disease, studies on the association between long-term exposure to air pollution and renal function are still contradictory. This study aimed to investigate this association in a large population with relatively low exposure and with improved estimation of renal function as well as renal injury biomarkers. Methods: We performed a cross-sectional analysis in the middle-aged general population participating in the Swedish CardioPulmonary bioImaging Study (SCAPIS; n = 30 154). Individual 10-year exposure to total and locally emitted fine particulate matter (PM2.5), inhalable particulate matter (PM10), and nitrogen oxides (NOx) were modelled using high-resolution dispersion models. Linear regression models were used to estimate associations between exposures and estimated glomerular filtration rate (eGFR, combined creatinine and cystatin C) and serum levels of renal injury biomarkers (KIM-1, MCP-1, IL-6, IL-18, MMP-2, MMP-7, MMP-9, FGF-23, and uric acid), with consideration of potential confounders. Results: Median long-term PM2.5 exposure was 6.2 µg/m3. Almost all participants had a normal renal function and median eGFR was 99.2 mL/min/1.73 m2. PM2.5 exposure was associated with 1.3% (95% CI 0.6, 2.0) higher eGFR per 2.03 µg/m3 (interquartile range, IQR). PM2.5 exposure was also associated with elevated serum matrix metalloproteinase 2 (MMP-2) concentration, with 7.2% (95% CI 1.9, 12.8) higher MMP-2 per 2.03 µg/m3. There was a tendency towards an association between PM10 and higher levels of uric acid, but no associations were found with the other biomarkers. Associations with other air pollutants were null or inconsistent. Conclusion: In this large general population sample at low exposure levels, we found a surprising association between PM2.5 exposure and a higher renal filtration. It seems unlikely that particle function would improve renal function. However, increased filtration is an early sign of renal injury and may be related to the relatively healthy population at comparatively low exposure levels. Furthermore, PM2.5 exposure was associated with higher serum concentrations of MMP-2, an early indicator of renal and cardiovascular pathology.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Air pollution, Biomarkers, eGFR, Kidney disease, Matrix metalloproteinases
in
Environmental Health: A Global Access Science Source
volume
23
issue
1
article number
67
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85200829625
  • pmid:39123230
ISSN
1476-069X
DOI
10.1186/s12940-024-01108-9
language
English
LU publication?
yes
id
f2808320-2635-4dec-bab7-4c5b0044f88c
date added to LUP
2024-08-30 11:39:24
date last changed
2024-08-31 03:00:10
@article{f2808320-2635-4dec-bab7-4c5b0044f88c,
  abstract     = {{<p>Background: Despite accumulating evidence of an association between air pollution and renal disease, studies on the association between long-term exposure to air pollution and renal function are still contradictory. This study aimed to investigate this association in a large population with relatively low exposure and with improved estimation of renal function as well as renal injury biomarkers. Methods: We performed a cross-sectional analysis in the middle-aged general population participating in the Swedish CardioPulmonary bioImaging Study (SCAPIS; n = 30 154). Individual 10-year exposure to total and locally emitted fine particulate matter (PM<sub>2.5</sub>), inhalable particulate matter (PM<sub>10</sub>), and nitrogen oxides (NO<sub>x</sub>) were modelled using high-resolution dispersion models. Linear regression models were used to estimate associations between exposures and estimated glomerular filtration rate (eGFR, combined creatinine and cystatin C) and serum levels of renal injury biomarkers (KIM-1, MCP-1, IL-6, IL-18, MMP-2, MMP-7, MMP-9, FGF-23, and uric acid), with consideration of potential confounders. Results: Median long-term PM<sub>2.5</sub> exposure was 6.2 µg/m<sup>3</sup>. Almost all participants had a normal renal function and median eGFR was 99.2 mL/min/1.73 m<sup>2</sup>. PM<sub>2.5</sub> exposure was associated with 1.3% (95% CI 0.6, 2.0) higher eGFR per 2.03 µg/m<sup>3</sup> (interquartile range, IQR). PM<sub>2.5</sub> exposure was also associated with elevated serum matrix metalloproteinase 2 (MMP-2) concentration, with 7.2% (95% CI 1.9, 12.8) higher MMP-2 per 2.03 µg/m<sup>3</sup>. There was a tendency towards an association between PM<sub>10</sub> and higher levels of uric acid, but no associations were found with the other biomarkers. Associations with other air pollutants were null or inconsistent. Conclusion: In this large general population sample at low exposure levels, we found a surprising association between PM<sub>2.5</sub> exposure and a higher renal filtration. It seems unlikely that particle function would improve renal function. However, increased filtration is an early sign of renal injury and may be related to the relatively healthy population at comparatively low exposure levels. Furthermore, PM<sub>2.5</sub> exposure was associated with higher serum concentrations of MMP-2, an early indicator of renal and cardiovascular pathology.</p>}},
  author       = {{Kilbo Edlund, Karl and Xu, Yiyi and Andersson, Eva M. and Christensson, Anders and Dehlin, Mats and Forsblad-d’Elia, Helena and Harari, Florencia and Ljunggren, Stefan and Molnár, Peter and Oudin, Anna and Svartengren, Magnus and Ljungman, Petter and Stockfelt, Leo}},
  issn         = {{1476-069X}},
  keywords     = {{Air pollution; Biomarkers; eGFR; Kidney disease; Matrix metalloproteinases}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Environmental Health: A Global Access Science Source}},
  title        = {{Long-term ambient air pollution exposure and renal function and biomarkers of renal disease}},
  url          = {{http://dx.doi.org/10.1186/s12940-024-01108-9}},
  doi          = {{10.1186/s12940-024-01108-9}},
  volume       = {{23}},
  year         = {{2024}},
}