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To investigate the associations between long-term air pollution exposures and estimated glomerular filtration rate (eGFR) in Shanghai, China (from October 2014 to May 2015).
A cross-sectional study was conducted in two hospitals affiliated to Tongji University (Tenth People's Hospital and Tongji Hospital) in Shanghai, China (N=4084). Serum creatinine was measured at each hospitalization, and eGFR was calculated using the CKD-EPI creatinine equation. Air pollution data and meteorological data (October 2014 to May 2015) were obtained from the database of Shanghai Environmental Monitoring Center (SEMC). Daily average concentration of particles with an aerodynamic diameter ≤ 10 μm (PM10), fine particles (≤ 2.5 μm; PM2.5), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO) were calculated from monitoring stations in the 7 districts of Shanghai. Generalized linear models was used to evaluate the associations between air pollution and eGFR.
During the study period, the average concentration of PM2.5, PM10, O3, NO2, SO2 and CO were 56.71 μg/m3, 79.58μg/m3, 90.43 μg/m3, 52.07μg/m3, 20.12μg/m3 and 0.87 mg/m3 respectively. After controlling for potential confounders, an interquartile range (IQR) increase (45μg/m3) in PM2.5 was associated with a 0.50 ml/min/1.73 m2 lower eGFR [95% confidence interval (CI): –0.93,–0.0.7]. A 58.5 μg/m3 IQR increase in PM10 was associated with a 0.70 ml/min/1.73 m2 lower eGFR [95% CI: –1.19, –0.20], and a 0.47 mg/m3 IQR increase in CO was associated with a 0.94 ml/min/1.73 m2 lower eGFR [95% CI: –1.47, –0.41]. The effects were stronger among patients ≥ 65 years old, BMI ≥ 24 kg/m2, female patients, and patients with hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, and patients who smoke or drink currently. These associations were not statistically significant in O3, SO2 and NO2.
The findings of this cross-sectional study indicated that long-term air pollution exposure to PM2.5, PM10 and CO was associated with lower estimated glomerular filtration rate.