Association of the components of ambient fine particulate matter (PM2.5) and chronic kidney disease prevalence in China.

Previous research has implicated PM 2.5 as a potential environmental risk factor for CKD, but little is known about the associations between its components and CKD. We conducted a nationwide cross-sectional study using the updated air pollution data in the nationwide population (N = 2,938,653). Using generalized additive models, we assessed the association between long-term exposure to PM 2.5 and its components (i.e., black carbon [BC], organic matter [OM], nitrate [NO 3 −], ammonium [NH 4 +], sulfate [SO 4 2−]), and CKD prevalence. The air pollution data was estimated using high-resolution and high-quality spatiotemporal datasets of ground-level air pollutants in China. Besides, we adopted a novel quantile-based g-computation approach to assess the effect of a mixture of PM 2.5 constituents on CKD prevalence. The average concentration of PM 2.5 was 78.67 ± 22.5 μg/m3, which far exceeded WHO AQG. In the fully adjusted generalized additive model, at a 10 km × 10 km spatial resolution, the ORs per IQR increase in previous 1-year average PM 2.5 exposures was 1.380 (95%CI: 1.345–1.415), for NH 4 + was 1.094 (95%CI: 1.062–1.126), for BC was 1.604 (95%CI: 1.563–1.646), for NO 3 − was 1.094 (95%CI: 1.060–1.130), for SO 4 2− was 1.239 (95%CI: 1.208–1.272), and for the OM was 1.387 (95%CI: 1.354–1.421), respectively. Subgroup analysis showed females, younger, and healthier were more vulnerable to this effect. In the further exploration of the joint effect of PM 2.5 compositions (OR 1.234 [95%CI 1.222–1.246]) per quartile increase in all 5 PM 2.5 components, we found that PM 2.5 SO 4 2− contributed the most. These findings provide important evidence for the positive relationship between long-term exposure to PM 2.5 and its chemical constituents and CKD prevalence in a Chinese health check-up population, and identified PM 2.5 SO 4 2− has the highest contribution to this relationship. This study provides clinical and public health guidance for reducing specific air particle exposure for those at risk of CKD. • Long-term exposure to PM 2.5 and its components is significantly associated with CKD prevalence. • Sulfate is the strongest contributor to the CKD prevalence among PM 2.5 components. • Our research provids updated evidence for clinical and public health guidance. [ABSTRACT FROM AUTHOR]

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