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Study attributes significant amount of kidney disease globally to PM2.5 pollution

The global toll of chronic kidney disease (CKD) attributable to PM2.5 pollution is significant, according to an analysis presented at ASN (American Society of Nephrology) Kidney Week. Benjamin Bowe, MPH, (Clinical Epidemiology Center at the VA Saint Louis Health Care System) and his colleagues previously described an association between increased levels of fine particulate matter and risk of developing CKD. (Earlier post.)

In this latest research, the investigators used the Global Burden of Disease study methodologies to estimate the burden of CKD attributable to fine particulate matter: more than 10.7 million cases per year.

The global burden of chronic kidney disease attributable to elevated PM2.5. expressed in disability adjusted life years (DALY) per 100,000 population. Click to enlarge.

Epidemiologic measures of the burden of CKD attributable to air pollution including years living with disability—meaning years living with kidney disease—(YLD); years of life lost—meaning early death attributable to kidney disease—(YLL); and disability-adjusted life years—a measure that combines the burden of living with the disease and the early death caused by the disease—(DALYs) suggest that the burden varies greatly by geography, with higher values seen in Central America and South Asia.

The estimate for the global annual burden of incident CKD attributable to elevated PM2.5 was 10,784,514 (95% Uncertainty Interval: 7,821,109-13,857,623). YLD, YLL, and DALYs of CKD attributable to elevated PM2.5 were 2,185,317 (1,418,442-3,061,477); 7,897,941 (5,471,081-10,514,433); and 10,083,258 (7,064,399-13,323,685) respectively.

Standardized ABD (attributable burden of disease) in the 10 most populated countries showed Nigeria, Bangladesh, Pakistan, and India having high ABDs, exceeding 200 incident cases of CKD per 100,000 population.

Populations in Mexico, Central America, Southeast Asia, India, and Northern Africa were amongst those with highest DALYs. For example, DALYs per 100,000 were 366.71 (251.05, 498.01) in Nicaragua and 353.93 (260.05-449.24) in Mexico, compared to 44.59 (24.07-65.74) in the United States.

Air pollution might at least partially explain the rise in incidence of CKD of unknown origin in many geographies around the world, and the rise in Mesoamerican nephropathy in Mexico and Central America.

—Benjamin Bowe


  • “The Global Burden of Kidney Disease Attributable to Air Pollution” (Abstract SA-OR056)


Earle Beach

The article mixes the language of causation, "attributable to," with that of correlation, "might at least partially explain." Close enough for government work perhaps (the VA, really?) but not strong enough for public policy.


Attempts to downgrade or fail relationship between pollution like PM 1.0 and 2.5 and health, increased health care cost, reduced productivity, our poor overall well being and shorten life span will lose out when we rise up and claim for damages.

A class action against gas-oil-coal producers and distributors, CPPs-NGPPs operators, ICEVs manufacturers, oil heating users etc is long overdue.

Earle Beach

No attempt to fail relationship over "health" here, just over kidneys. Any such lawsuit would need more than sloppy language confounding correlation and causation to support it. To move on to causation it would need to 1) show that all other possible causes are ruled out, and 2) present a viable model to show how insult to the lungs works it way through all intermediate organs and processes to affect the kidneys.

To demonstrate just how costly confusion over correlation and causation can be in the medical industry we just have to look at the recently routine American practice of male infant circumcision. About 100,000,000 American were unnecessarily circumcised based on bad science. This was supposed to reduce the incidence of cervical cancer among American women. The connection? Women in countries that routinely circumcised their boys had a lower rate. But three generations later our rate hasn't gone down. Obviously circumcision was not the solution. How did we go wrong? We confused correlation with causation.

So what causes that lower rate of cervical cancer in those other countries? Genetics. The people in countries are Semites: Jews and Arabs. The same groups of people most likely to get Tay-Sachs are least likely to get cervical cancer.

Think of how we could more productively used the money spent on those 100,000,000 unnecessary surgeries.

There is also a problem with this article linking man-made PM to kidney disease. Looking at the map we see that the red and orange areas are not the most developed countries, thus not the ones artificially producing the most PM. The orange and red locations mark the world's largest deserts. Their PM is not natural.

Earle Beach

Oops, I thought I'd proofread that. Last line should be "Their PM **is** natural."


So taking folks to court because they heat their homes in winter with oil is the solution to this problem.

Truly remarkable nonsense.


Older Wood, Coal, Oil and NG fired furnaces are some of the worst sources of air pollution and GHGs.

They have to go!!!

Clean electricity from Hydro-Wind-Solar etc can easily be used instead. Recent high-low temps high efficiency heat pumps can reduce the energy required by up to 66%.

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