Associations between long term air pollution exposure and first hospital admission for kidney and total urinary system diseases in the US Medicare population: nationwide longitudinal cohort study.

To estimate the associations between long term exposure to air pollution and the first hospital admission related to kidney and total urinary system diseases. Nationwide longitudinal cohort study. Data were collected from the Medicare fee-for-service for beneficiaries living in 34 849 zip codes across the continental United States from 2000 to 2016. Exposure variables were annual averages of traffic related pollutants (fine particles (PM All beneficiaries aged 65 years or older who were enrolled in Medicare part A fee-for-service (n=61 097 767). First hospital admission with diagnosis codes for total kidney and urinary system disease or chronic kidney disease (CKD), analyzed separately. The average annual concentrations of air pollution were 9.8 µg/m The findings suggest that higher annual air pollution levels were associated with increased risk of first hospital admission related to diseases of the kidney and urinary system or CKD in the Medicare population.

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Competing interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: support from the US Environmental Protection Agency and National Research Foundation of Korea for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.