Short-term ambient particle radioactivity level and renal function in older men: Insight from the Normative Aging Study

Abstract

Background: Whole-body and thoracic ionizing radiation exposure are both associated with the development of renal dysfunction. However, whether low-level environmental radiation from air pollution affects renal function remains unknown.

Objectives: We investigated the association of particle radioactivity (PR) with renal function defined by the estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) in the Normative Aging Study.

Methods: This longitudinal analysis included 2491 medical visits from 809 white males enrolled between 1999 and 2013. The eGFR was calculated using the CKD-EPI and MDRD equations, and CKD cases were identified as those with an eGFR <60 mL/min/1.73 m². Gross β activity measured by five monitors of the U.S. Environmental Protection Agency's RadNet monitoring network was utilized to represent PR.

Results: Ambient PR levels from 1 to 28 days prior to clinical visit demonstrated robust negative associations with both forms of eGFR, but not with the increased odds of CKD. An interquartile range higher 28-day average ambient PR level was significantly associated with 0.83-mL/min/1.73 m² lower eGFR estimated by the CKD-EPI equation (95% confidence interval: -1.46, -0.20, p-value = 0.01). Controlling for PM_2.5 or black carbon in the model slightly attenuated the PR effects on eGFR. However, in individuals with the highest levels (3rd tertile) of C-reactive protein (CRP) or fibrinogen, we observed robust associations of PR with eGFR and CKD, suggesting that systemic inflammation may modify the PR-eGFR and PR-CKD relationships.

Conclusions: Our study reveals adverse health effects of short-term low-level ambient PR on the renal function, providing evidence to guide further study of the interplay between PR, inflammation, and renal health.

Keywords: Air pollution; CKD; Particle radioactivity; Renal function; eGFR.

Figure 1

Associations between particle radioactivity and kidney function in the exposure window of 28 days with and without controlling for air pollution PR: particle radioactivity; BC: black carbon; eGFR: estimated glomerular filtration rate Dots: Point estimates; Error bars: Confidence intervals; Red: Model with particle radioactivity only; Green: Model with particle radioactivity and PM_2.5; Blue: Model with particle radioactivity and black carbon;