Abstract
Chronic kidney disease (CKD), a global disease burden related to high rates of incidence and mortality, manifests as progressive and irretrievable nephron loss and decreased kidney regeneration capacity. Emerging studies have suggested that exposure to air pollution is closely relevant to increased risk of CKD, CKD progression and end-stage kidney disease (ESKD). Inhaled airborne particles may cause vascular injury, intraglomerular hypertension, or glomerulosclerosis through non-hemodynamic and hemodynamic factors with multiple complex interactions. The mechanisms linking air pollutants exposure to CKD include elevated blood pressure, worsening oxidative stress and inflammatory response, DNA damage and abnormal metabolic changes to aggravate kidney damage. In the present review, we will discuss the epidemiologic observations linking air pollutants exposure to the incidence and progression of CKD. Then, we elaborate the potential roles of several air pollutants including particulate matter and gaseous co-pollutants, environmental tobacco smoke, and gaseous heavy metals in its pathogenesis. Finally, this review outlines the latent effect of air pollution in ESKD patients undergoing dialysis or renal transplant, kidney cancer and other kidney diseases. The information obtained may be beneficial for further elucidating the pathogenesis of CKD and making proper preventive strategies for this disease.
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Abbreviations
- CKD:
-
chronic kidney disease
- PM2.5 :
-
particulate matter with aerodynamic diameter<2.5μm
- PM1 :
-
particulate matter with aerodynamic diameter<1μm
- PM10 :
-
particulate matter with aerodynamic diameter<10μm
- ESKD:
-
end-stage kidney disease
- ETS:
-
environmental tobacco smoke
- CO2 :
-
carbon dioxide
- SO2 :
-
sulfur dioxide
- NO2 :
-
nitrogen dioxide
- CO:
-
carbon monoxide
- O3 :
-
ozone
- SHSE:
-
secondhand smoke exposure
- ROS:
-
reactive oxygen species
- nAChR:
-
nicotinic acetylcholine receptors
- EGFR:
-
estimated glomerular filtration rate
- DEP:
-
diesel exhaust particles
- DPM:
-
diesel particulate matter
- APOL1:
-
apolipoprotein L1
- ER:
-
endoplasmic reticulum
- PWV:
-
pulse wave velocity
- PT:
-
proximal tubule
- LN:
-
lupus nephritis
- Cd:
-
cadmium
- As:
-
arsenic
- Pb:
-
lead
- Akt:
-
protein kinase B
- mTOR:
-
mammalian target of rapamycin
- IL-6:
-
interleukin-6
- RAS:
-
renin angiotensin system
- KKS:
-
kallikrein kinin system
- NADPH:
-
nicotinamide adenine dinucleotide phosphate
- NLRP6:
-
nucleotide-binding domain (NOD) like receptor protein 6
- Hg:
-
mercury
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This work was supported by the National Natural Science Foundation of China (Grant Number 81872687).
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Yue Chen and Fan Cao: Writing - original draft. Hai-Feng Pan and De-Guang Wang: Writing – review and editing. Xin-Yu Fang, Jian-Ping Xiao, Xue-Rong Wang, and Li-Hong Ding: Supervision.
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Chen, Y., Cao, F., Xiao, JP. et al. Emerging role of air pollution in chronic kidney disease. Environ Sci Pollut Res 28, 52610–52624 (2021). https://doi.org/10.1007/s11356-021-16031-6
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DOI: https://doi.org/10.1007/s11356-021-16031-6