Impact of Particulate Matter With an Aerodynamic Diameter <2.5 μm Concentration on Postoperative Renal Function in Living Kidney Donors

Ambient air pollution has become 1 of the most important public health issues worldwide. In particular, particulate matter with an aerodynamic diameter <2.5 μm (PM_2.5) is a fatal component of air pollution. We aimed to analyze whether perioperative exposure to PM_2.5 is associated with the deterioration of renal function in living kidney donors.

This study was conducted on 232 kidney donors with postoperative 2-year glomerular filtration rate (GFR). The GFR was determined by serum creatinine-based method using the Modification of Diet in Renal Disease equation and radionuclide-based method using ^99mTc-DTPA renal scintigraphy. Perioperative exposure to PM_2.5 was calculated using data from the AIRKOREA System. Multiple linear and logistic regression analyses were performed to estimate the associations between mean PM_2.5 concentration and postoperative 2-year GFR.

Postoperative Modification of Diet in Renal Disease-estimated GFRs of kidney donors with low PM_2.5 concentrations were significantly higher than those of those with high PM_2.5 concentrations. A 1-μg/m³ increase in mean PM_2.5 concentration was associated with decreased GFR by 0.20 mL/min/1.73 m². In addition, a 1-μg/m³ increase in mean PM_2.5 concentration was associated with an 11% increased risk of chronic kidney disease stage ≥3 at 2 years after donor nephrectomy.

In patients who underwent donor nephrectomy, exposure to PM_2.5 negatively affects renal function and is positively associated with the prevalence of chronic kidney disease.