Kidney Week

Abstract: FR-PO1019

Association of Long-Term Exposure to Air Pollution with Population-Level Rates of Incident ESKD in the United States

Session Information

• Social, Environmental, and Economic Determinants of Kidney Health
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Johansen, Kirsten L., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States

Kirsten L. Johansen, MD, FASN

• Liu, Jiannong, Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States

Jiannong Liu, PhD

• Drawz, Paul E., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States

Paul E. Drawz, MD, MS

• Wetmore, James B., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States

James B. Wetmore, MD, MS

• Gilbertson, David T., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States

David T. Gilbertson, PhD

• Roetker, Nicholas S., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States

Nicholas S. Roetker, MS, PhD

• Weinhandl, Eric D., Davita Clinical Research, Minneapolis, Minnesota, United States

Eric D. Weinhandl, MS, PhD

• Berman, Jesse David, University of Minnesota Twin Cities School of Public Health, Minneapolis, Minnesota, United States

Jesse David Berman, MHS, PhD

Background

Patient-level analyses suggest that long-term exposure to air pollution is associated with higher risk of incident end-stage kidney disease (ESKD). We sought to examine the extent to which geographic variations in the rate of incident end-stage kidney disease (ESKD) are correlated with long-term exposure to air pollution.

Methods

We used air pollution models from NASA’s Socioeconomic Data and Applications Center to estimate long-term exposure to fine particulate matter <2.5 μm in aerodynamic diameter (PM_2.5) at the county level. We calculated the 10-year average PM_2.5 concentration from 2007-2016 and assigned each county the value derived from the county’s population-weighted centroid based on the 2010 US Census. We used data from the US Renal Data System to calculate county-level rates of incident ESKD in 2018-2022 based on population estimates from the 2020 Census. We mapped PM_2.5 concentration and examined the association between PM_2.5 concentration and the subsequent incidence of ESKD among counties with ≥15,000 residents (excluding 3.4% of the population residing in counties too small to generate stable ESKD incidence).

Results

There was wide variation in exposure to PM_2.5 with large areas in the Midwest and Southeast having levels ≥10 μg/m³ (left panel of Fig). There was also considerable variation in incident ESKD rates, from 64 to 16,789 per million population. PM_2.5 concentration was significantly correlated with incident ESKD rate (Spearman correlation =0.26; right panel of Fig).

Conclusion

Long-term exposure to air pollution was associated with rates of incident ESKD at the population level. Further analysis is needed to examine whether this association may partially explain racial/ethnic and socioeconomic disparities in rates of incident ESKD.

Funding

• NIDDK Support