Elevated exposure to air pollutants accelerates primary glomerular disease progression

Jonathan P Troost; Abhijit V Kshirsagar; Lawrence S Engel; Cassandra R O'Lenick; William E Smoyer; Jon Klein; Margaret Helmuth; Laura H Mariani; Matthias Kretzler; Abigail R Smith; Forrest Lacey; Howard Trachtman

doi:10.1093/ckj/sfaf140

Elevated exposure to air pollutants accelerates primary glomerular disease progression

Clin Kidney J. 2025 May 13;18(6):sfaf140. doi: 10.1093/ckj/sfaf140. eCollection 2025 Jun.

Authors

Affiliations

¹ Michigan Institute for Clinical & Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA.
² Departments of Medicine, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC, USA.
³ Departments of Epidemiology and Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC, USA.
⁴ The Abigail Wexner Research Institute at Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
⁵ Department of Medicine, Division of Nephrology and Hypertension, Christina Lee Brown Environment Institute, University of Louisville School of Medicine, University of Louisville, Louisville, KY, USA.
⁶ Robley Rex Veterans Administration Medical Center, Louisville, KY, USA.
⁷ Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
⁸ Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA.
⁹ Department of Preventive Medicine, Division of Biostatistics and Informatics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹⁰ National Science Foundation National Center for Atmospheric Research, Boulder, CO, USA.
¹¹ Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA.

Abstract

Air pollution is a global problem and a major contributor to adverse health outcomes in patients of all ages. Most research has focused on the adverse effects of air pollution on cardiopulmonary events such as myocardial infarction, stroke and lung disease, with less attention given to kidney outcomes. In recent years, there is emerging evidence that air pollution contributes to the onset and progression of chronic kidney disease and, specifically, glomerular disease. This has been confirmed in epidemiological studies performed around the world. In this review, we summarize: (i) the major sources and components of air pollution; (ii) published reports detailing the relationship between air pollution exposure and the incidence and the clinical course of chronic kidney disease; and (iii) the existing literature assessing the impact of air pollution on the progression of primary glomerular diseases. We highlight important gaps in knowledge and the need for future collaborative work involving environmental scientists, epidemiologists and nephrologists to better understand the contribution of air pollution to the increasing number of people worldwide with chronic kidney disease. This work is important because air pollution exposure represents a potentially modifiable risk factor for chronic kidney disease progression that can be addressed by regulatory action, personal behaviors and implementation of interventions to prevent or limit exposure.

Keywords: IgA nephropathy; air pollution; glomerular disease; membranous nephropathy; particulate matter 2.5 (PM2.5).

Publication types

Review

Abstract

Publication types

Grants and funding