Air Pollution and Kidney Diseases: PM2.5 as an Emerging Culprit.

Clinical Background: As a result of modern industrialization, air pollution has become a potential contributor to global burden of noncommunicable diseases, such as cardiovascular disease, respiratory disease, and kidney disease. Epidemiology: Emerging epidemiological evidence has demonstrated that exposure to ambient air pollution is associated with an increased risk for the development and progression of chronic kidney disease (CKD) and CKD-related mortality. Exposure to PM2.5, even at relatively low concentrations, is a risk factor for a lower estimated glomerular filtration rate and a faster decline in glomerular filtration rate. It has been estimated that the global burden of CKD attributable to PM2.5 is 6.95 million incident cases of CKD per year. Low- and middle-income countries in the Eastern Mediterranean and South-East Asia regions experienced the highest urban air pollution levels, thus facing a heavier burden of related disease. Challenges: Despite a growing awareness of kidney damage related to air pollution, large gaps still exist between the exact toxicological effect of particles on the kidney and the increasing prevalence of air pollution-related kidney diseases. Considering the geographic variation of air pollution, more longitudinal studies in different parts of the world are urgently needed, especially in those most affected countries. Prevention and Treatment: Air pollution control should be regarded as a high priority in urban plan and policy making. Actions are required to narrow gaps in knowledge and clean air, thus preventing air pollution-related kidney disease.