Elevated Exposure to Air Pollutants Accelerates Primary Glomerular Disease Progression

Area of Science:

• Nephrology
• Environmental Health
• Epidemiology

Background:

• Environmental factors contributing to kidney disease progression are not fully understood.
• Primary glomerulopathies represent a significant cause of kidney disease.

Purpose of the Study:

• To investigate the association between residential air pollution exposure and kidney disease progression in patients with primary glomerulopathies.
• To explore potential molecular mechanisms linking air pollution to kidney disease progression.

Main Methods:

• Utilized data from the Nephrotic Syndrome Study Network (NEPTUNE) and CureGlomerulonephropathy (CureGN) cohorts.
• Employed Cox proportional hazards models to assess the impact of PM2.5, black carbon (BC), and sulfate exposure on kidney disease progression (≥40% eGFR decline or kidney failure).
• Measured serum tumor necrosis factor (TNF) and kidney tissue transcriptomic inflammatory pathway activation as biomarkers.

Main Results:

• Higher PM2.5 and BC exposure were associated with increased risk of kidney disease progression in a combined analysis of both cohorts.
• Sulfate and PM2.5 exposure correlated with elevated serum TNF and interleukin-1β levels.
• Sulfate exposure was linked to the activation of TNF and JAK-STAT signaling pathways in kidney tissue.

Conclusions:

• Elevated exposure to PM2.5 and BC is linked to accelerated kidney disease progression in primary glomerulopathies.
• Air pollution exposure may promote kidney disease progression through systemic inflammation and activation of inflammatory pathways.