Kidney Week

Abstract: FR-PO1088

Ambient Air Pollutant Mixture, Sleep Pattern, and Incident CKD: Results from a Prospective Cohort Study

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

• Zhang, Feifei, Peking University Health Science Center, Beijing, China

Feifei Zhang, PhD

• Yang, Chao, Peking University First Hospital Department of Nephrology, Beijing, China

Chao Yang, MS, MPH

• Zhang, Luxia, Peking University Health Science Center, Beijing, China

Luxia Zhang, MD, MPH

Background

The associations of sleep behavior and air pollution with chronic kidney disease (CKD) have been investigated individually, yet the role of their interaction in the incidence of CKD is not well understood.

Methods

This study involved 402,451 participants from the UK Biobank cohort. A composite sleep index was calculated according to five sleep behaviors including sleep duration, chronotype, insomnia symptoms, snoring, and daytime sleepiness. Seven air pollutants, including PM_2.5, PM₁₀, NO₂, NO_X, SO₂, CO, and benzene, were examined jointly and individually. Cox proportional hazards model was used to calculate associations and to investigate potential modifying effects by assessing the significance of cross-product interaction terms of sleep index and air pollutants.

Results

With a median follow-up duration of 13.6 years, 3.6% of the participants was diagnosed with CKD. Each of the seven air pollutants demonstrated a positive association with the incidence of CKD. Co-exposure to seven air pollutants was associated with an increased risk of CKD incidence (hazard ratio: 1.093, 95% confidence interval: 1.067-1.119, Figure 1). There was a significant multiplicative interaction between sleep index and combined air pollutant exposure and the risk of incident CKD (p for interaction: 0.014). Stratified analyses by sleep index showed that the negative effect of air pollution was less pronounced for participants with healthier sleep patterns. Similar interactions existed for individual air pollutants including PM₁₀, NO₂, NO_X, and CO. Subgroup analyses suggested the elderly and females may experience fewer toxic effects from air pollution by adhering to healthy sleep patterns.

Conclusion

Sleep patterns may modify the relationship between air pollution exposure and onset of CKD. Our study highlights the potential of improving sleep as a preventive measure to counteract the detrimental effects of air pollution on incident CKD.

Figure 1. Hazard ratios and 95% CIs for chronic kidney disease associated with joint exposure to seven air pollutants in the total population and subpopulations stratified by sleep index. HR, hazard ratio. CI, confidence interval.

Funding

• Government Support – Non-U.S.