title: Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China.
abstract: The effect of air pollution on the changing pattern of glomerulopathy has not been studied. We estimated the profile of and temporal change in glomerular diseases in an 11-year renal biopsy series including 71,151 native biopsies at 938 hospitals spanning 282 cities in China from 2004 to 2014, and examined the association of long-term exposure to fine particulate matter of <2.5 μm (PM2.5) with glomerulopathy. After age and region standardization, we identified IgA nephropathy as the leading type of glomerulopathy, with a frequency of 28.1%, followed by membranous nephropathy (MN), with a frequency of 23.4%. Notably, the adjusted odds for MN increased 13% annually over the 11-year study period, whereas the proportions of other major glomerulopathies remained stable. During the study period, 3-year average PM2.5exposure varied among the 282 cities, ranging from 6 to 114 μg/m3(mean, 52.6 μg/m3). Each 10 μg/m3increase in PM2.5concentration associated with 14% higher odds for MN (odds ratio, 1.14; 95% confidence interval, 1.10 to 1.18) in regions with PM2.5concentration >70 μg/m3We also found that higher 3-year average air quality index was associated with increased risk of MN. In conclusion, in this large renal biopsy series, the frequency of MN increased over the study period, and long-term exposure to high levels of PM2.5was associated with an increased risk of MN.
authors.affiliation: Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China.
authors.forename: Guobao
authors.initials: G
authors.lastname: Wang
authors.affiliation: Renal Division, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
authors.affiliation: Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Lu
authors.affiliation: Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Nie
authors.affiliation: Renal Division, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.affiliation: Renal Division, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Renal Division, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China.
authors.forename: Yongping
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.affiliation: Department of Renal Pathology, King Medical Diagnostics Center, Guangzhou, China; and ffhouguangzhou@163.com geng@fimmu.com.|Department of Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Geng
authors.affiliation: Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China; ffhouguangzhou@163.com geng@fimmu.com.
authors.forename: Fan Fan
authors.initials: FF
authors.lastname: Hou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000009:adverse effects*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002681:China; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter; D018570:Risk Assessment; D013997:Time Factors; D055815:Young Adult
chemical_list: D052638:Particulate Matter
keywords: air pollution; membranous nephropathy; renal biopsy