New research reveals the hidden dangers of air pollution to kidney function and survival.
Study: Prolonged air pollution exposure and risk of acute kidney injury and related mortality: a prospective cohort study based on hospital-acquired AKI and general population controls from the UK Biobank. Image credit: New Africa/Shutterstock.com
In a recent study published in BMC Public Healthresearchers looked at the long-term effect of air pollution on kidney health, focusing specifically on acute kidney injury and associated mortality.
They found that prolonged exposure to pollutants such as particulate matter below 2.5 microns (PM2.5) and nitric oxides significantly increased the risk of acute kidney injury.
Background
A major contributor to the development of chronic kidney disease and end-stage renal disease is acute kidney injury, where kidney function undergoes a sudden decline.
Despite significant advances in medical research, acute kidney injury still poses long-term health risks, making it vital to identify and prevent the factors that lead to it.
Air pollution has been closely linked to kidney disease. Inhaled pollutants can reach the kidneys through the bloodstream and cause oxidative stress and inflammation.
Although previous studies have examined the relationship between exposure to air pollutants such as nitrogen oxides and PM2.5 and chronic kidney disease, there is a paucity of studies investigating the relationship between air pollution and acute kidney injury.
About the study
In the present study, the researchers investigated the impact of long-term exposure to PM2.5particles below 10 microns (PM10), and nitrogen oxides in the risk of acute kidney injury and deaths due to acute kidney injury.
Data were collected from a large cohort in the United Kingdom (UK). Biobank, researchers looked at whether air pollution increased the likelihood of acute kidney injury.
The cohort consisted of more than 500,000 participants aged between 40 and 69 years who were recruited to the UK Biobank team between 2006 and 2010.
The researchers excluded people who had acute kidney injury and those who had missing data on demographic characteristics or air pollution exposure before the start of the study, resulting in a final data set of about 415,000 people.
Hospital admission records were used to identify cases of acute kidney injury during the study period, and the investigators used International Statistical Classification of Diseases Tenth Revision (ICD-10) codes to determine whether the acute kidney injury was of the tubular necrosis or cortical necrosis type. Mortality due to acute kidney injury was also identified.
In addition, the study assessed exposure to different air pollutants such as nitrogen dioxide, nitrogen oxides, PM2.5and PM10. The researchers used the Land Use Regression model to estimate pollution levels in each participant’s area of residence.
This model takes into account environmental factors such as traffic, population density and land use to predict the annual average concentration of pollutants in an area. The accuracy of the model estimates was also validated.
In addition, the study accounted for a wide range of variables that could potentially influence the results, including demographic factors such as gender, age, and ethnicity. medical history including hypertension, diabetes and body mass index; and lifestyle choices such as alcohol consumption and smoking.
The analysis also took into account the use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and angiotensin-converting enzyme (ACE) inhibitors, and included laboratory results for C-reactive protein and creatinine levels in the analysis.
Results
The findings confirmed that prolonged exposure to air pollutants was associated with a higher risk of acute kidney injury and related mortality.
The study found a linear, as well as nonlinear, relationship between exposure to nitrogen oxides and fine particles and kidney-related health outcomes, with some pollutants showing complex dose-response patterns.
More specifically, exposure to PM2.5nitrogen oxides and nitrogen dioxide were associated with an increased risk of death from acute kidney injury. However, the risk of developing acute kidney injury showed a non-linear relationship with various pollutants, indicating that the impact of air pollution on kidney health may vary with exposure levels.
The researchers also investigated the potential biological mechanisms underlying the relationship between exposure to air pollutants and increased risk of acute kidney injury. The study suggested that inhaled pollutants reaching the kidney through the bloodstream could cause oxidative stress and inflammation, which could damage kidney function.
In addition, pre-existing health conditions such as hypertension and diabetes could increase vulnerability to the harmful effects of air pollution on kidney health.
conclusions
Overall, the study highlighted the critical impact of long-term exposure to air pollutants such as nitrogen oxides and fine particles on kidney health and highlighted the need for strict regulations and policies to monitor air quality.
These findings also support the value of integrating kidney health into public health and environmental policies to improve overall health and reduce the burden of acute kidney injury.
Journal Reference:
Liu, M., Gao, M., Hu, D., Hu, J., Wu, J., Chen, Z., & Chen, J. (2024). Prolonged exposure to air pollution and risk of acute kidney injury and related mortality: a prospective cohort study based on hospital-acquired AKI and general population controls from the UK Biobank. BMC Public Health24(1), 2911. doi:10.1186/s12889024203212.
