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)