Tuesday, February 17, 2015

Does Air Pollution Cause Kidney Disease?

County-Level Air Quality and the Prevalence of Diagnosed Chronic Kidney Disease in the U.S. Medicare Population (Abstract, page 824, Jennifer L. Bragg-Gresham, Hal Morgenstern, William M. McClellan, Sharon Saydah, Desmond Williams, Neil R. Powe, Delphine S. Tuot, Yi Li,1 Rajiv Saran, American Society of Nephrology, Nov. 11-16, 2014) 

 Also discussed here: Air pollution associated with higher rates of chronic kidney disease (Science Daily, Nov. 16, 2014) 

 Today we review research into the link between air pollution and chronic kidney disease or CKD. Results indicate higher prevalence of the disease with particulate (PM2.5) readings as low as 8.4 μg/m3, much lower than the expected threshold of 40 μg/m3 for elderly patients. Higher incidence of CKD may be expected in countries or regions with higher air pollution levels than where this research was conducted in counties across the USA. 

 Key Quotes: 

“the investigators found a positive association between the prevalence of diagnosed chronic kidney disease [CKD] and county level of particulate matter less than 2.5 micrometers in diameter. This finding remained true after controlling for major patient-level risk factors for chronic kidney disease such as age, diabetes, and hypertension.” 

“An elevated prevalence of CKD was observed when particulate matter levels were as low as 8.4 μg/m3, which is much lower than levels typically considered unhealthy for sensitive groups such as the elderly (~40 μg/m3). "

We found that poorer air quality was associated with higher prevalence of CKD. However, the cross-sectional design and lack of individual exposure data precludes causal inference” 

"If air pollution is a risk factor for CKD, the impact is likely to be even greater in countries where pollution levels are much higher than in the U.S. Future investigations should include lab-based diagnosis of CKD, longitudinal data, measures of multiple air pollutants and individual exposure, and more extensive control of confounding factors,"

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