We found that long-term exposure to each air pollutant, including PM2.5, PM10, NO2, and NOx, and joint exposure to the five air pollutants (PM2.5, PM2.5-10, PM10, NO2, and NOx) were significantly associated with a higher risk of incident kidney stones. One possible mechanism is that exposure to air pollution leads to oxidative stress and systemic inflammation, and there is growing evidence that inflammation and oxidation-antioxidant imbalances play an important role in the development of kidney stones. Consistently, our previous studies found that supplementation with glucosamine and fish oil was associated with a lower risk of kidney stones, suggesting that anti-inflammatory and antioxidant treatment may have a possible benefit in reducing kidney stone risk.1, 2
Of note, we observed a stronger positive association between the air pollution score and new-onset kidney stones in those without diabetes. Diabetes can also increase systemic inflammation and oxidative stress, which may contribute to the development of kidney stones. Therefore, diabetes and air pollutants seem to share some common pathogenic mechanisms to increase the risk of kidney stones. As such, it is understandable that the detrimental effect of air pollution on incident kidney stones among individuals with diabetes was attenuated. Our study suggests that controlling both diabetes and air pollution may be a more comprehensive strategy for the prevention of kidney stones.
In summary, we found that long-term exposure to air pollution was significantly associated with a high risk of kidney stones, regardless of the individual's genetic risk of kidney stones. Our findings highlight the importance of a comprehensive assessment of various air pollutants in the primary prevention of kidney stones.
Written by: Xianhui Qin, MD & Xiaoqin Gan, MD
National Clinical Research Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
References:
- Gan X, Zhou C, He P, et al. Inverse association of glucosamine use and risk of new-onset kidney stones in UK adults with less sedentary time. Prev Med. 2023; 177: 107738.
- Gan X, Liu M, He P, et al. Habitual fish oil supplementation, genetic susceptibility of kidney stones, and the risk of new-onset kidney stones. J Clin Lipidol. Published online November 27, 2023.