Air pollution-associated chronic kidney disease (APA-CKD): Evidence from a cross-sectional study of Niger Delta communities

Abstract

Objective Air pollution is an emerging risk factor for chronic kidney disease (CKD) that is typically ignored in preventive interventions. This study investigated whether long-term exposure to ambient air pollution in communities near petrochemical industries in the Niger Delta was associated with CKD. Design A cross-sectional study with an embedded citizen science inquiry. Settings Four communities situated at varying distances from a petrochemical refinery in Niger Delta, Nigeria. Participants We obtained sociodemographic, behavioural, exposure history and clinical data from 1460 participants who have resided for at least 5 years in the four communities. A citizen science approach was used to monitor air pollutant concentrations with eight community volunteers. Results The mean PM 2.5, PM 10 and volatile organic compounds (VOC) concentrations exceeded the WHO-acceptable limits in all four communities. CO 2 was acceptable in the farthest communities from the refinery, while O 3 was within acceptable limits in all communities. The total hazard quotient was relatively higher in the two communities near the refinery (11.27, 11.63) than those farther (9.63, 10.68), F=0.038, p=0.989. The overall prevalence of CKD was 12.3%; it was 17.9% in the community closest to the refinery and 8.0% in the farthest (χ 2 =18.292, p=0.004). Increasing age was the only independent risk factor for CKD after adjusting for confounding factors and intrahousehold design effect (adjusted OR 1.26; 95% CI 1.09 to 1.45, p=0.002). Conclusion Long-term exposure to ambient air pollution may increase CKD risk in susceptible populations. Social factors and environmental exposures associated with CKD are prevalent in the communities, necessitating multifaceted and inclusive approaches to mitigate air pollution and the associated kidney disease risks. More studies are required to explore the mechanism of air pollution-associated kidney disease and interventions to reverse or limit it.