Background.Increasing evidence from human studies has revealed the adverse impact of ambient fine particles(PM_(2.5))on health outcomes related to metabolic disorders and distant organs.Whether exposure to ambient PM_...Background.Increasing evidence from human studies has revealed the adverse impact of ambient fine particles(PM_(2.5))on health outcomes related to metabolic disorders and distant organs.Whether exposure to ambient PM_(2.5)leads to kidney impairment remains unclear.The rapid air quality improvement driven by the clean air actions in China since 2013 provides an opportunity for a quasiexperiment to investigate the beneficial effect of PM_(2.5)reduction on kidney function.Methods.Based on two repeated nationwide surveys of the same population of 5115 adults in 2011 and 2015,we conducted a difference-indifference study.Variations in long-term exposure to ambient PM_(2.5)were associated with changes in kidney function biomarkers,including estimated glomerular filtration rate by serum creatinine(GFRscr)or cystatin C(GFRcys),blood urea nitrogen(BUN),and uric acid(UA).Results.For a 10μg/m^(3)reduction in PM_(2.5),a significant improvement was observed for multiple kidney functional biomarkers,including GFRscr,BUN and UA,with a change of 0.42(95%confidence interval[CI]:0.06,0.78)mL/min/1.73m^(2),-0.38(-0.64,-0.12)mg/dL,and-0.06(-0.12,-0.00)mg/dL,respectively.A lower socioeconomic status,indicated by rural residence or low educational level,enhanced the adverse effect of PM_(2.5)on kidney function.Conclusions.These results support a significant nephrotoxicity of PM_(2.5)based on multiple serum biomarkers and indicate a beneficial effect of improved air quality on kidney function.展开更多
基金the National Natural Science Foundation of China(4217050142)PKU-Baidu Fund(2020BD031)+2 种基金Energy Foundation(G-2107-33169 and R-2109-33379)the Funda-mental Research Funds for the Central Universities(BMU2021YJ042)CAMS Innovation Fund for Medical Sciences(2017-I2M-1-004).
文摘Background.Increasing evidence from human studies has revealed the adverse impact of ambient fine particles(PM_(2.5))on health outcomes related to metabolic disorders and distant organs.Whether exposure to ambient PM_(2.5)leads to kidney impairment remains unclear.The rapid air quality improvement driven by the clean air actions in China since 2013 provides an opportunity for a quasiexperiment to investigate the beneficial effect of PM_(2.5)reduction on kidney function.Methods.Based on two repeated nationwide surveys of the same population of 5115 adults in 2011 and 2015,we conducted a difference-indifference study.Variations in long-term exposure to ambient PM_(2.5)were associated with changes in kidney function biomarkers,including estimated glomerular filtration rate by serum creatinine(GFRscr)or cystatin C(GFRcys),blood urea nitrogen(BUN),and uric acid(UA).Results.For a 10μg/m^(3)reduction in PM_(2.5),a significant improvement was observed for multiple kidney functional biomarkers,including GFRscr,BUN and UA,with a change of 0.42(95%confidence interval[CI]:0.06,0.78)mL/min/1.73m^(2),-0.38(-0.64,-0.12)mg/dL,and-0.06(-0.12,-0.00)mg/dL,respectively.A lower socioeconomic status,indicated by rural residence or low educational level,enhanced the adverse effect of PM_(2.5)on kidney function.Conclusions.These results support a significant nephrotoxicity of PM_(2.5)based on multiple serum biomarkers and indicate a beneficial effect of improved air quality on kidney function.
