Associations of long-term exposure to PM2.5 and its constituents with children renal function: a national retrospective study in China.

INTRODUCTION

Ambient fine particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) harms adult's renal health. However, research on the associations of PM2.5 and its chemical constituents (black carbon (BC), ammonium ( [Formula: see text] ), nitrate (NO3-), organic matter (OM), and sulfate (SO42-)) with children' kidney health is lacking.

OBJECTIVES

The aim of this research was to estimate the associations between long-term exposures to PM2.5 and its constituents and children' estimated glomerular filtration rate (eGFR).

METHODS

We investigated 9770 children from 5 provinces across China during 2016-2017. The eGFR was calculated from serum creatinine. We estimated the mean concentration of PM2.5 and PM2.5 compositions (BC, [Formula: see text] , NO3-, OM, SO42-) during pregnancy, infancy and preschool period for each subject. A generalized linear mixed-effects model was utilized to estimate associations of PM2.5 and its constituents with eGFR. Stratified analyses were conducted to explore effect modifications of sex and urbanicity.

RESULTS

During the full pregnancy, each interquartile range (IQR) increase in PM2.5 mass (49.07 μg/m3), SO42- (9.14 μg/m3), BC (1.85 μg/m3), [Formula: see text] (7.38 μg/m3), NO3- (12.23 μg/m3) and OM (9.02 μg/m3) was associated with decreased eGFR (ml/min/1.73 m2), with changes of -1.80 (95 % CI: -2.82, -0.78), -1.70 (95 % CI: -2.71, -0.69), -1.83 (95 % CI: -2.63, -1.03), -6.87 (95 % CI: -8.44, -5.30), -7.24 (95 % CI: -9.02, -5.45), and -2.20 (95 % CI: -3.12, -1.28), respectively. In infancy, higher levels of BC, [Formula: see text] , NO3-, and OM were negatively associated with eGFR, and similar associations were found during the preschool period for [Formula: see text] , NO3-, and OM. Furthermore, children living in rural areas were particularly sensitive to PM2.5.

CONCLUSION

Long-term exposures to PM2.5 and some constituents were negatively associated with children's eGFR. Additionally, the associations of [Formula: see text] and NO3- constituents were more pronounced with renal health than the other chemical constituents. Targeted policies are needed to protect kidney health from PM2.5 exposure.