Air Pollution Linked To Increased Risk Of Kidney Disease

Everyone knows that breathing dirty air is bad for your lungs, but did you also know that polluted air may be bad for your kidneys, substantially increasing your risk for kidney disease? If you’re a kidney disease patient, if you’re at risk for kidney disease, or if you love someone who is, you’re about to learn some details that you need to know – about the air you breathe.

Research in the past has hinted at the impact of air pollution on the kidneys. Coal mining towns often report high rates of kidney disease, and lab mice forced to breathe exhaust particles show the symptoms of kidney damage. Now, recently published research strongly suggests that air pollution may cause, contribute to, and exacerbate chronic kidney disease.

Stated simply, bad air is bad for the kidneys. Dr. Ziyad Al-Aly of the Veterans Affairs St. Louis Health Care System, one of the research team leaders, flatly states, “Air pollution is a risk factor for kidney disease development.” He told Reuters Health, “You can argue that it’s even more of a problem in countries like China or India, where pollution is much, much, much worse.”

WHAT ARE THE DETAILS BEHIND THE RESEARCH?

The research was published online in September in the Journal of the American Society of Nephrology. The research team assessed the medical data for more than 2.4 million veterans – data compiled over more than eight years – in an attempt to gauge the impact of air pollution on the kidneys.

When we breathe bad air, we inhale particulate matter, tiny fragments in the air that are produced by industrial processes that include fossil fuel combustion. Fragments with a diameter tinier than 2.5 micrometers may be inhaled deeply and easily. The particles are already linked to strokes, diabetes, heart disease, and shorter life spans.

Researchers compared the medical conditions of the vets, including information on the glomerular filtration rate (a measure of kidney function), against county-by-county air pollution data supplied by the Environmental Protection Agency and by NASA.

WHAT WERE THE RESEARCH FINDINGS?

The research team found that veterans residing in counties with the highest particulate matter levels were more likely to belong to two high-risk categories for kidney disease. First, they were predominantly African-American, and secondly, they suffered predominantly from diabetes and high blood pressure.

As researchers reviewed the entire eight years of medical data for the veterans, they learned that higher particulate matter levels were statistically consistent with a heightened risk for end-stage renal disease, when kidneys no longer function and dialysis – or a kidney transplant – is necessary to keep a kidney disease patient alive.

The New York Times report on the research study emphasized these conclusions: “The scientists calculate that ‘unhealthy’ pollution levels lead to an annual increase of 44,793 cases of chronic kidney disease, and 2,438 cases of end-stage kidney disease requiring dialysis. Even levels below those considered ‘safe’ increased risk.”

Possibly most disturbing is the finding that even at pollution levels below the Environmental Protection Agency’s recommended limit of 12 micrograms per cubic meter, kidney damage was significant. “The message is that no level of air pollution is really safe,” says Dr. Al-Aly.

For each increase of ten micrograms of fine particulates per cubic meter of air, the risk of kidney disease rose by 27 percent, and the risk of kidney failure rose by 26 percent. Dr. Al-Aly and his researchers were not able to prove a conclusive, direct link between particulate matter and chronic kidney disease, but we know that particulate matter can spread to the kidneys through the bloodstream, causing stress, inflammation, and probably other damage to the kidneys.

DID OTHER RESEARCHERS AGREE WITH THESE FINDINGS?

Reuters Health asked Dr. Jennifer Bregg-Gresham of the Kidney Epidemiology and Cost Center at the University of Michigan to review the research conducted by Dr. Al-Aly’s team. She concluded, “These new findings support that even low levels of fine particulate matter air pollution across the U.S. can increase the risk of serious kidney problems.”

“Given the millions of people with and at-risk for kidney disease who are impacted by air pollution, this has serious public health implications,” Dr. Bregg-Gresham added. She suggests that exposure to particulate matter can be reduced with indoor air purification, and in heavily polluted cities, using an inexpensive respirator N95 facemask.

Vlado Perkovic, a kidney specialist at the George Institute for Global Health in Sydney, Australia, also reviewed the findings. “It’s an incredibly careful analysis,” according to Perkovic. He also said, “These findings are going to have huge public health relevance.”

HOW WIDESPREAD IS KIDNEY DISEASE IN THE U.S.?

The findings may also explain why some people with none of the typical indicators of risk for kidney disease – such as hypertension and diabetes – still develop the condition. Nearly 45,000 new patients with chronic kidney disease are diagnosed each year in the United States. That’s in addition to an estimated 26 million of us who are already struggling with kidney disease.

With so many kidney disease patients, the opportunities for serious medical mistakes are abundant. With the proper treatment, kidney disease can usually be halted or slowed at the earliest stages and managed without great inconvenience. Without proper testing, diagnosis, and treatment, chronic kidney disease will inevitably advance to total kidney failure.

When you have a medical checkup, urine tests and blood tests are routine. If the results are misinterpreted, or if the indications of kidney disease are not even recognized, a specialist won’t be consulted, treatment will not proceed, and a patient’s kidney health can deteriorate rapidly. That constitutes medical malpractice, and if it happens to you, you’ll want to discuss your rights with an experienced medical malpractice attorney.

HOW IS MEDICAL MALPRACTICE DEFINED?

Medical malpractice is defined as the violation of the “reasonable standard of care” provided by most doctors, but it is usually difficult for a kidney disease patient to know whether he or she is a medical malpractice victim. Every malpractice case is unique, and every accusation of malpractice must be thoroughly investigated by an experienced medical malpractice attorney.

If you don’t have chronic kidney disease, chances are that you know someone who does – perhaps in your own family. The truth is that medical malpractice in the United States is responsible for more deaths each year than kidney disease.

The victims of medical malpractice are often entitled to substantial compensation, and their actions also protect others by deterring future incidents of malpractice. Don’t risk your health. If you even suspect that you or your loved one may be a medical malpractice victim, speak to an experienced medical malpractice attorney at once.

By: Jed Kurzban

Medical malpractice attorney Jed Kurzban graduated from the University of Alabama in 1992 and earned his Juris Doctor from the University of Miami School of Law in 1995. He is a member of the Dade County Bar Association, the Florida Bar Association, the American Association for Justice, the Academy of Florida Trial Lawyers, and the American Bar Association. Mr. Kurzban is happily married and the father of two.