Long-term joint exposure of outdoor air pollutants and impaired kidney function in Korean adults: A mixture analysis based on a nationwide sample (2007-2019).

We explored the association between exposure to air pollutant mixture and renal function. A nationwide sample of 69,066 Korean adults was analyzed. The 1-year moving averages of the concentrations of PM10, PM2.5, SO₂, NO₂, CO, and O₃ were estimated using the air pollution modeling. The outcome was estimated glomerular filtration rate (eGFR) value. Quantile-based G-computation analyses were performed to determine how a simultaneous increase in the air pollutant mixture by one quartile was associated with changes in eGFR levels. The mean of eGFR was 88.9 among the sample. In the quantile-based G-computation model, one-quartile increase in the levels of air pollutant mixture was linked to a decrease in eGFR by -0.85 (95 % CI: -1.14, -0.57), with CO and PM2.5 contributing 52.3 % and 37.3 %, respectively, to the negative association between the pollutant mixture and eGFR. Our results suggest that long-term exposure to air pollutant mixtures is linked to impaired renal function.