Background

Articles concerning the correlation of the risk of chronic kidney disease (CKD) with air contaminant exposure present inconsistent findings and the magnitude of the link is still unclear. Therefore, we planned to systematically and quantitatively investigate the overall strength of proofs in this field.

Methods

Relevant articles on Cochrane, EMBASE, Medline, Web of Science, and CINHAL were searched as per relevant strategies. Only observational studies that disclosed the link of CKD risk with major air pollutants were enrolled, including PM10 and PM2.5, which were particulate matter less than 10 um and less than 2.5 um in erodynamic diameter respectively. Pooled relative risk (RR) and 95 % confidence interval (CI) were determined using random--effects models, regardless of the heterogeneity quantified by I² statistic.

Results

Finally, 7 studies involving 5,812,381 participants were included. The incidence of CKD was increased by long-term exposure to PM10 (including solely estimated exposure to PM10 from studies using PM2.5) (RR 1.08, 95 %CI 1.04–1.11) with considerable heterogeneity (I² = 79 %), and the risk of CKD was raised by 8% when the long-time exposure to PM10 increased by 10 ug/m³. The pooled RR (95 %CI) with a 10 μg/m³ increase in PM2.5 for risk of CKD was 1.09 (1.03–1.17). Stratified analysis also verified the general negative effects.

Conclusions

Chronic subjection to major air contaminants (PM10 and PM2.5) is more likely to cause CKD. Thus, developing global approaches of air pollution elimination to prevent CKD is urgent.

中文翻译：

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慢性肾脏疾病与主要空气污染物的关系-观察性研究的系统评价和荟萃分析

背景

关于慢性肾脏病（CKD）风险与空气污染物暴露相关性的文章，发现不一致，相关程度还不清楚。因此，我们计划系统地和定量地研究该领域中证据的整体实力。

方法

根据相关策略，搜索有关Cochrane，EMBASE，Medline，Web of Science和CINHAL的相关文章。只有观察性研究揭示了CKD风险与主要空气污染物之间的关系，其中包括PM10和PM2.5，它们的颗粒直径分别小于10 um和小于2.5 um。无论采用I ²统计量化的异质性如何，均使用随机效应模型确定合并的相对风险（RR）和95％置信区间（CI）。

结果

最后，纳入了5 812 381名参与者的7项研究。长期暴露于PM10（包括使用PM2.5进行的研究得出的对PM10的单独估算暴露）会增加CKD的发生率（RR 1.08，95％CI 1.04–1.11），且异质性相当大（I ² = 79％），并且当长期暴露于PM10的时间增加10 ug / m ³时，CKD的风险增加8％。合并的RR（95％CI）与PM2.5引起CKD的风险增加10μg/ m ³为1.09（1.03-1.17）。分层分析也验证了普遍的负面影响。

结论

长期受到主要空气污染物（PM10和PM2.5）的感染更容易引起CKD。因此，迫切需要开发出全球性的消除空气污染的方法来预防CKD。