National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China.
Nat Rev Nephrol. 2018 May;14(5):313-324. doi: 10.1038/nrneph.2018.11. Epub 2018 Feb 26.
The burden of disease and death attributable to environmental pollution is becoming a public health challenge worldwide, especially in developing countries. The kidney is vulnerable to environmental pollutants because most environmental toxins are concentrated by the kidney during filtration. Given the high mortality and morbidity of kidney disease, environmental risk factors and their effect on kidney disease need to be identified. In this Review, we highlight epidemiological evidence for the association between kidney disease and environmental pollutants, including air pollution, heavy metal pollution and other environmental risk factors. We discuss the potential biological mechanisms that link exposure to environmental pollutants to kidney damage and emphasize the contribution of environmental pollution to kidney disease. Regulatory efforts should be made to control environmental pollution and limit individual exposure to preventable or avoidable environmental risk. Population studies with accurate quantification of environmental exposure in polluted regions, particularly in developing countries, might aid our understanding of the dose-response relationship between pollutants and kidney diseases.
环境污染导致的疾病和死亡负担正在成为全球范围内的公共卫生挑战，尤其是在发展中国家。肾脏容易受到环境污染的影响，因为大多数环境毒素在过滤过程中会被肾脏浓缩。鉴于肾脏病的高死亡率和发病率，需要确定环境风险因素及其对肾脏病的影响。在这篇综述中，我们强调了流行病学证据表明肾脏病与环境污染之间存在关联，包括空气污染、重金属污染和其他环境风险因素。我们讨论了将环境污染暴露与肾脏损伤联系起来的潜在生物学机制，并强调了环境污染对肾脏病的贡献。应采取监管措施来控制环境污染，限制个人接触，以预防可避免的环境风险。在污染地区，特别是在发展中国家，进行具有环境污染准确量化的人群研究，可能有助于我们了解污染物与肾脏病之间的剂量-反应关系。
