Association between ambient PM and the prevalence of chronic kidney disease in China: A nationwide study.

Particulate of diameter ≤ 1 µm (PM) presents a novel risk factor of adverse health effects. Nevertheless, the association of PM with the risk of chronic kidney disease (CKD) in the general population is not well understood, particularly in regions with high PM levels like China. Based on a nationwide representative survey involving 47,204 adults and multi-source ambient air pollution inversion data, the present study evaluated the association of PM with CKD prevalence in China. The two-year average PM, particulate of diameter ≤ 2.5 µm (PM), and PM values were accessed using a satellite-based random forest approach. CKD was defined as estimated glomerular filtration rate < 60 ml/min/1.73 m or albuminuria. The results suggested that a 10 μg/m rise in PM was related to a higher CKD risk (odds ratio [OR], 1.13; 95% confidence interval [CI] 1.08-1.18) and albuminuria (OR, 1.11; 95% CI, 1.05-1.17). The association between PM and CKD was more evident among urban populations, older adults, and those without comorbidities such as diabetes or hypertension. Every 1% increase in the PM/PM ratio was related to the prevalence of CKD (OR, 1.03; 95% CI, 1.03-1.04), but no significant relationship was found for PM. In conclusion, the present study demonstrated long-term exposure to PM was associated with an increased risk of CKD in the general population and PM might play a leading role in the observed relationship of PM with the risk of CKD. These findings provide crucial evidence for developing air pollution control strategies to reduce the burden of CKD.