Indian Council of Medical Research-National Institute for Research in Environmental Health, Bhopal, India.
Sanjay Gandhi Post Graduate Institute, Lucknow, India.
Int Arch Occup Environ Health. 2022 Jul;95(5):897-908. doi: 10.1007/s00420-021-01808-6. Epub 2021 Oct 30.
Air pollution results from a variable and complex mixture of harmful gases and suspended particles and is the most worrisome of all environmental hazards. It is implicated in several non -communicable diseases and is recognized to be a public health problem. Though the initial exposure to air pollution is through the respiratory system, kidneys are thought to be exposed to higher concentrations owing to their filtration function. Chronic kidney disease is the insidious end result of several disease processes which cumulatively form a large healthcare burden, particularly in low- and middle-income countries. There is a growing body of evidence that air pollution may be a contributing factor that leads to CKD by not only its direct effects, but can also compound the effect of other factors/diseases causing kidney injury. PM exposure particularly has been implicated, although there is some evidence regarding other air pollutants as well. These pollutants are thought to act on kidneys through several interlinked systemic pathways and mechanisms which individually and collectively damage the nephrons. Long-term exposures seem to gradually diminish renal function and lead to end-stage renal disease. A thorough understanding of the mechanism of kidney injury is the key for formulating and implementing effective strategies for reducing this burden. Maintaining the air quality, promoting education, improving health quality and promotion of targeted nephroprotective measures through effective policy and research support are required in addressing this global public health problem.
空气污染是由有害气体和悬浮颗粒的可变和复杂混合物引起的，是所有环境危害中最令人担忧的。它与几种非传染性疾病有关，被认为是一个公共卫生问题。尽管最初接触空气污染是通过呼吸系统，但由于肾脏具有过滤功能，人们认为它们会接触到更高浓度的污染物。慢性肾脏病是多种疾病过程的潜在终末结果，这些疾病过程累积起来构成了巨大的医疗保健负担，尤其是在低收入和中等收入国家。越来越多的证据表明，空气污染可能是导致慢性肾脏病的一个因素，不仅因为其直接影响，还因为它可能加重其他导致肾脏损伤的因素/疾病的影响。特别是 PM 暴露已被牵涉其中，尽管也有一些关于其他空气污染物的证据。这些污染物被认为通过几个相互关联的全身途径和机制作用于肾脏，这些途径和机制单独和共同损害肾单位。长期暴露似乎会逐渐降低肾功能，导致终末期肾病。深入了解肾脏损伤的机制是制定和实施有效策略以减轻这一负担的关键。为了解决这一全球公共卫生问题，需要维持空气质量、开展教育、提高健康质量和通过有效的政策和研究支持促进有针对性的肾脏保护措施。
