Air pollution linked to kidney disease risk

(Reuters Health) – Breathing dirty air may increase the risk for kidney problems, a study in U.S. veterans suggests.

“Air pollution is a risk factor for kidney disease development,” Dr. Ziyad Al-Aly of the Veterans Affairs St. Louis Health Care System in St. Louis, Missouri, who helped conduct the research, told Reuters Health by phone. “You can argue that it’s even more of a problem in countries like China or India, where pollution is much, much, much worse.”

Dr. Al-Aly and his team studied particulate matter (PM), tiny fragments produced by fossil fuel combustion and other industrial processes, that can be inhaled deep into the lungs. High levels of PM 2.5 – meaning particles smaller than 2.5 micrometers across – are associated with heart disease, stroke, diabetes and a shorter life span.

To investigate whether PM might harm the kidneys as well, the researchers looked at more than eight years’ worth of data on nearly 2.5 million military veterans, using county-by-county pollution data from the Environmental Protection Agency (EPA). Vets living in counties with the highest PM levels were more likely to be African-American and to have high blood pressure and diabetes – both of which are also risk factors for kidney disease – as well as heart disease.

The risk that the veterans’ kidney function would worsen over time rose in tandem with the level of pollution they were exposed to at the study’s outset. Higher PM concentrations in the air were also associated with an increased risk of end-stage renal disease, in which the kidney can no longer filter blood effectively and a person requires dialysis to stay alive.

When Dr. Al-Aly and his colleagues repeated the analysis using National Aeronautics and Space Administration satellite pollution data, the results were consistent.

Nearly 45,000 new cases of kidney disease are diagnosed each year in the U.S., and it’s possible that some of those might be due to PM 2.5 pollution that exceeds EPA standards, according to the researchers. But even levels well below the EPA threshold are associated with significant risk, Dr. Al-Aly said.

The study wasn’t a controlled experiment, so it can’t prove that air pollution actually caused the kidney problems. Some other health- or lifestyle-related factors might be to blame.

Still, Dr. Aly-Aly said, studies in animals have shown that particles breathed into the lungs can reach the kidneys via the bloodstream, causing inflammation and oxidative stress…

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