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PM2.5 linked to increased rates of kidney disease in China

While fine particulate air pollution is known to cause respiratory and cardiovascular diseases, a new study indicates that it also likely causes damage to the kidneys. Specifically, the study found that the likelihood of developing membranous nephropathy, an immune disorder of the kidneys that can lead to kidney failure, increased 13% annually from 2004 to 2014 in China. Regions with high levels of fine particulate air pollution had the highest rates of membranous nephropathy.

The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), call for attention on the role of air pollution in the development of kidney disease in urban areas.

Air pollution has become a serious problem in many cities in China, but the extent of its impact on individuals’ health is unclear. To examine how particulate matter in the air is affecting kidney health, a team led by Fan Fan Hou, MD, PhD and Xin Xu, MD, PhD (Southern Medical University, in Guangzhou, China) analyzed data on kidney biopsies taken over 11 years from 71,151 patients from 938 hospitals in 282 cities across China, encompassing all age groups. They examined the association of long-term exposure to fine particulate matter of <2.5 μm (PM2.5) with glomerulopathy—a set of diseases affecting the glomeruli (networks of capillaries located at the beginning of the nephron, the basic functional unit of the kidney).

After age and region standardization, they identified IgA nephropathy (caused when immunoglobulin A (IgA) builds up in the kidneys, leading to local inflammation) as the leading type of glomerulopathy, with a frequency of 28.1%. This was followed by membranous nephropathy (MN, occurring when the small blood vessels in the glomeruli become inflammed and thickened), with a frequency of 23.4%.

The adjusted odds for MN increased 13% annually over the 11-year study period, whereas the proportions of other major glomerulopathies remained stable.

During the study period, the 3-year average PM2.5 exposure varied among the 282 cities, ranging from 6 to 114 μg/m3 (mean, 52.6 μg/m3). Each 10 μg/m3 increase in PM2.5 concentration associated with 14% higher odds for MN (odds ratio, 1.14; 95% confidence interval, 1.10 to 1.18) in regions with PM2.5 concentration >70 μg/m3.

In conclusion, in this large renal biopsy series, the frequency of MN increased over the study period, and long-term exposure to high levels of PM2.5 was associated with an increased risk of MN.

—Xu et al.

Our primary finding is that the frequency of membranous nephropathy has doubled over the last decade in China. We show that the increase corresponds closely with the regional distribution of particulate air pollution.

—Dr. Hou

Resources

  • Xin Xu, Guobao Wang, Nan Chen, Tao Lu, Sheng Nie, Gang Xu, Ping Zhang, Yang Luo, Yongping Wang, Xiaobin Wang, Joel Schwartz, Jian Geng, and Fan Fan Hou (2016) “Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China” JASN doi: 10.1681/ASN.2016010093

Comments

DaveD

So....living in a toxic cloud isn't good for you? NO WAY!!!!

HarveyD

Pollution (the invincible killer) currently kills about 7,000,000 people/year and indirectly probably 2X or 3X as many but newspapers keep on writing about civil wars killing a mere 125,000/year in Irak and Syria and gun/car accident killing another 75,000+/year in USA.

Why are we fed the wrong news most of the time?

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