Associations between long-term exposure to air pollution and kidney function utilizing electronic healthcare records: a cross-sectional study
Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures. Our primary objective is to examine creatinine-based estimated glomerula...
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| Published in | Environmental health Vol. 23; no. 1; p. 43 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BioMed Central Ltd
23.04.2024
BioMed Central BMC |
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| Abstract | Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures.
Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFR
) and diagnosis of CKD and potential associations with fine particulate matter (PM
), ozone (O
), and nitrogen dioxide (NO
) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFR
using the serum creatinine-based 2021 CKD-EPI equation. PM
and NO
data come from a hybrid model using 1 km
grids and O
data from 12 km
CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFR
per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables.
We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m
(95% CI: -1.96, -1.31) reduction in eGFRcr, with O
and NO
showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFR
< 60 mL/min/1.73m
. NO
was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90).
One-year average PM
was associated with reduced eGFR
, while O
and NO
were inversely associated. Neither PM
or O
were associated with a first-time identification of CKD, NO
was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. |
|---|---|
| AbstractList | Abstract Background Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures. Methods Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFRcr) and diagnosis of CKD and potential associations with fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFRcr using the serum creatinine-based 2021 CKD-EPI equation. PM2.5 and NO2 data come from a hybrid model using 1 km2 grids and O3 data from 12 km2 CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFRcr per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables. Results We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m2 (95% CI: -1.96, -1.31) reduction in eGFRcr, with O3 and NO2 showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFRcr < 60 mL/min/1.73m2. NO2 was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90). Conclusions One-year average PM2.5 was associated with reduced eGFRcr, while O3 and NO2 were inversely associated. Neither PM2.5 or O3 were associated with a first-time identification of CKD, NO2 was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures. Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFR.sub.cr) and diagnosis of CKD and potential associations with fine particulate matter (PM.sub.2.5), ozone (O.sub.3), and nitrogen dioxide (NO.sub.2) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFR.sub.cr using the serum creatinine-based 2021 CKD-EPI equation. PM.sub.2.5 and NO.sub.2 data come from a hybrid model using 1 km.sup.2 grids and O.sub.3 data from 12 km.sup.2 CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFR.sub.cr per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables. We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m.sup.2 (95% CI: -1.96, -1.31) reduction in eGFRcr, with O.sub.3 and NO.sub.2 showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFR.sub.cr < 60 mL/min/1.73m.sup.2. NO.sub.2 was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90). One-year average PM.sub.2.5 was associated with reduced eGFR.sub.cr, while O.sub.3 and NO.sub.2 were inversely associated. Neither PM.sub.2.5 or O.sub.3 were associated with a first-time identification of CKD, NO.sub.2 was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. Background Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures. Methods Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFR.sub.cr) and diagnosis of CKD and potential associations with fine particulate matter (PM.sub.2.5), ozone (O.sub.3), and nitrogen dioxide (NO.sub.2) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFR.sub.cr using the serum creatinine-based 2021 CKD-EPI equation. PM.sub.2.5 and NO.sub.2 data come from a hybrid model using 1 km.sup.2 grids and O.sub.3 data from 12 km.sup.2 CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFR.sub.cr per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables. Results We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m.sup.2 (95% CI: -1.96, -1.31) reduction in eGFRcr, with O.sub.3 and NO.sub.2 showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFR.sub.cr < 60 mL/min/1.73m.sup.2. NO.sub.2 was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90). Conclusions One-year average PM.sub.2.5 was associated with reduced eGFR.sub.cr, while O.sub.3 and NO.sub.2 were inversely associated. Neither PM.sub.2.5 or O.sub.3 were associated with a first-time identification of CKD, NO.sub.2 was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. Keywords: Chronic kidney disease, Air pollution, Fine particulate matter, Ozone, Nitrogen dioxide, Electronic healthcare records BackgroundChronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures.MethodsOur primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFRcr) and diagnosis of CKD and potential associations with fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFRcr using the serum creatinine-based 2021 CKD-EPI equation. PM2.5 and NO2 data come from a hybrid model using 1 km2 grids and O3 data from 12 km2 CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFRcr per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables.ResultsWe found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m2 (95% CI: -1.96, -1.31) reduction in eGFRcr, with O3 and NO2 showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFRcr < 60 mL/min/1.73m2. NO2 was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90).ConclusionsOne-year average PM2.5 was associated with reduced eGFRcr, while O3 and NO2 were inversely associated. Neither PM2.5 or O3 were associated with a first-time identification of CKD, NO2 was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures. Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFR ) and diagnosis of CKD and potential associations with fine particulate matter (PM ), ozone (O ), and nitrogen dioxide (NO ) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFR using the serum creatinine-based 2021 CKD-EPI equation. PM and NO data come from a hybrid model using 1 km grids and O data from 12 km CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFR per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables. We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m (95% CI: -1.96, -1.31) reduction in eGFRcr, with O and NO showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFR < 60 mL/min/1.73m . NO was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90). One-year average PM was associated with reduced eGFR , while O and NO were inversely associated. Neither PM or O were associated with a first-time identification of CKD, NO was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. |
| ArticleNumber | 43 |
| Audience | Academic |
| Author | Moyer, Joshua Schwartz, Joel Di, Qian Dillon, David Weaver, Anne Ward-Caviness, Cavin Kshirsagar, Abhijit V |
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| Keywords | Air pollution Ozone Chronic kidney disease Fine particulate matter Nitrogen dioxide Electronic healthcare records |
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| Snippet | Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex,... Background Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology... Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex,... BackgroundChronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology... BACKGROUNDChronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology... Abstract Background Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD... |
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| SubjectTerms | Adult Aged Aged, 80 and over Air Pollutants - adverse effects Air Pollutants - analysis Air pollution Air Pollution - adverse effects Air Pollution - analysis Chronic kidney disease Chronic kidney failure Codes Comorbidity Creatinine Creatinine - blood Cross-Sectional Studies Development and progression Diagnosis Electronic Health Records Electronic healthcare records Electronic records Environmental aspects Environmental Exposure - adverse effects Environmental Exposure - analysis Exposure Female Females Fine particulate matter Glomerular Filtration Rate Health aspects Health care Humans Hypertension Kidney diseases Kidneys Male Medical care Middle Aged Mortality Nitrogen dioxide Nitrogen Dioxide - adverse effects Nitrogen Dioxide - analysis North Carolina - epidemiology Outdoor air quality Ozone Ozone - adverse effects Ozone - analysis Particulate matter Particulate Matter - adverse effects Particulate Matter - analysis Patients Phenotyping Physiological aspects Pollutants Renal function Renal Insufficiency, Chronic - chemically induced Renal Insufficiency, Chronic - epidemiology Risk factors Standard deviation Time measurement Utilization |
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| Title | Associations between long-term exposure to air pollution and kidney function utilizing electronic healthcare records: a cross-sectional study |
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