Kidney Week

Abstract: FR-PO1090

Effects of Environmental Factors on the Progression of CKD in Inhabitants of São Paulo, Brazil

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Moreira, Tiana Carla Lopes, Nephrology, University of São Paulo School of Medicine, São Paulo, SP, Brazil

Tiana Carla Lopes Moreira, ScD

• Tammaro, Alessandra, Amsterdam UMC, Amsterdam Cardiovascular Science, University of Amsterdam, Amsterdam, Netherlands

Alessandra Tammaro, PhD

• Mauad, Thais, Pathology, University of São Paulo School of Medicine, São Paulo, SP, Brazil

Thais Mauad, PhD

• Santos, Itamar de Souza, Internal Medicine, University of São Paulo School of Medicine, São Paulo, SP, Brazil

Itamar de Souza Santos, PhD

• Andrade, Maria, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, São Paulo, SP, Brazil

Maria Andrade, PhD

• Andrade, Lucia, Nephrology, University of São Paulo School of Medicine, São Paulo, SP, Brazil

Lucia Andrade, MD, PhD

• Kers, Jesper, Amsterdam UMC, Amsterdam Cardiovascular Science, University of Amsterdam, Amsterdam, Netherlands

Jesper Kers, MD, PhD

Background

Epidemiological evidence links air pollution to an increased risk of developing chronic diseases. Exposure to air pollution, especially PM₁₀ and PM_2.5, has received special attention due to its potential associations with cardiovascular disease (CVD), diabetes mellitus, lung cancer and chronic obstructive pulmonary disease, but its relationship with CKD is still poorly established. In Brazil, around 11% of the population suffers from CKD. We aim to evaluate the relationship between the progression of CKD and exposure to environmental factors such as air pollution, green areas, built-up areas, traffic density in the City of São Paulo in a wave of the Brazilian Longitudinal Study of Adult Health.

Methods

For each participant, we assessed demographic data, environmental data, and risk factors. Two different indicators of exposure to green spaces were used: number of street trees and land cover. Land cover classification was based on the random forest algorithm using geometrically corrected aerial photography (orthophotos). Pollutant exposure was evaluated indirectly using the distance-weighted traffic density of the participant residence and from using the annual mean concentration of PM₁₀ (µg/m³) at the monitoring station closest to the participant residence. Linear regression models were used to evaluate the importance of the environment on CKD progression; the dependent variables were GFR (CKD-EPI), albuminuria (mg/g creatinine) and microalbuminuria (mg/dL), whereas the independent variables were demographic data, environmental data and risk factors.

Results

Cardiac risk according to the American Heart Association, obesity and lower educational level were associated with a higher risk of GFR decline. We also found that traffic density was marginally associated with GFR decline (β = 0.004; CI: 0.008–0.001; p = 0.098). In addition to their associations with CVD and obesity, albuminuria and microalbuminuria were found to correlate inversely with the number of trees (β = 0.03 ; CI: 0.06–0.00; p = 0.04 and β = 0.002; CI: 0.004–0.001; p = 0.05).

Conclusion

To decrease exposure to air pollution and slow the progression of CKD, large-scale street tree planting should be encouraged.

Funding

• Government Support – Non-U.S.