Associations of PM_2.5 components with dynamic and accelerated progression of different kidney function states and subsequent cardiovascular events: The GOLD-Health cohort.

Authors

Manting Rao, Jiamin Chen, Peng Hu, Zhonghua Ai, Menghe Wang, Xiangyi Liu, Zhoubin Zhang, Hualiang Lin

Published in

International journal of cardiology. Pages 134999. Oct 17, 2026. Epub Oct 17, 2026.

Abstract

Fine particulate matter (PM_2.5) has been associated with an increased risk of chronic kidney disease (CKD) and cardiovascular disease (CVD). However, the relationships between specific PM_2.5 components and the dynamic cardiorenal trajectory remain uncertain.
Employing multistate and accelerated failure time (AFT) modeling in a prospective cohort of 307,639 participants, we examined the associations of 2-year exposure to PM_2.5 and its components (sulfate [SO₄^2-], nitrate [NO₃^-], ammonium [NH₄⁺], organic matter [OM], and black carbon [BC]) with dynamic and accelerated progression from different kidney function categories (1-4, according to estimated glomerular filtration rate [eGFR] and self-reported CKD) to CVD, and ultimately to cardiovascular death.
Over 1,058,210 person-years of follow-up, we documented 23,948 CVD cases and 7763 cardiovascular death cases. We observed that PM_2.5 and its components were significantly associated with the dynamic cardiorenal trajectory, with SO₄^2-, NO₃^-, and NH₄⁺ exhibiting larger hazard ratios (HRs). Per-interquartile range (IQR) increments in SO₄^2-, NO₃^-, and NH₄⁺ were positively correlated with the transition from kidney function category 2 to 3, and the HRs were 1.273 (95% confidence interval [CI]: 1.257-1.289), 1.304 (95% CI: 1.290-1.317), and 1.280 (95% CI: 1.267-1.294), respectively. The AFT model indicated that higher levels of PM_2.5 and its constituents significantly accelerated the dynamic cardiorenal trajectory. The predictive transition times from kidney function category 2 to 3 for 2-year NO₃^- exposure were 1727.43 days at 4.2 μg/m³ and 868.56 days at 7.0 μg/m³.
Our findings revealed that PM_2.5 components (2-year exposure) may be important risk factors for adverse cardiorenal outcomes.

PMID:
42892469
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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