PuSH - Publication Server of Helmholtz Zentrum München: Long-term exposure to air pollution and chronic kidney disease-associated mortality - results from the pooled cohort of the European multicentre ELAPSE-study.

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Kadelbach, P.* ; Weinmayr, G.* ; Chen, J.* ; Jaensch Dipl-Dok, A.* ; Rodopoulou, S.* ; Strak, M.* ; de Hoogh, K.* ; Andersen, Z.J.* ; Bellander, T.* ; Brandt, J.* ; Cesaroni, G.* ; Fecht, D.* ; Forastiere, P.F.* ; Gulliver, P.J.* ; Hertel, O.* ; Hoffmann, B.* ; Hvidtfeldt, U.A.* ; Katsouyanni, P.K.* ; Ketzel, M.* ; Leander, K.* ; Ljungman, P.* ; Magnusson, P.K.E.* ; Pershagen, G.* ; Rizzuto, D.* ; Samoli, E.* ; Severi, G.* ; Stafoggia, M.* ; Tjønneland, P.A.* ; Vermeulen, R.* ; Peters, A. ; Wolf, K. ; Raaschou-Nielsen, P.O.* ; Brunekreef, B.* ; Hoek, G.* ; Zitt, E.* ; Nage, P.G.*

Long-term exposure to air pollution and chronic kidney disease-associated mortality - results from the pooled cohort of the European multicentre ELAPSE-study.

Environ. Res. 252:118942 (2024)

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Despite the known link between air pollution and cause-specific mortality, its relation to chronic kidney disease (CKD)-associated mortality is understudied. Therefore, we investigated the association between long-term exposure to air pollution and CKD-related mortality in a large multicentre population-based European cohort. Cohort data were linked to local mortality registry data. CKD-death was defined as ICD10 codes N18-N19 or corresponding ICD9 codes. Mean annual exposure at participant's home address was determined with fine spatial resolution exposure models for nitrogen dioxide (NO₂), black carbon (BC), ozone (O₃), particulate matter ≤2.5μm (PM_2.5) and several elemental constituents of PM_2.5. Cox regression models were adjusted for age, sex, cohort, calendar year of recruitment, smoking status, marital status, employment status and neighbourhood mean income. Over a mean follow-up time of 20.4 years, 313 of 289 564 persons died from CKD. Associations were positive for PM_2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03-1.66) per 5μg/m³, BC (1.26 (1.03-1.53) per 0.5×10^{- 5}/m), NO₂ (1.13 (0.93-1.38) per 10μg/m³) and inverse for O₃ (0.71 (0.54-0.93) per 10μg/m³). Results were robust to further covariate adjustment. Exclusion of the largest sub-cohort contributing 226 cases, led to null associations. Among the elemental constituents, Cu, Fe, K, Ni, S and Zn, representing different sources including traffic, biomass and oil burning and secondary pollutants, were associated with CKD-related mortality. In conclusion, our results suggest an association between air pollution from different sources and CKD-related mortality.

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