Abstract
Exposure to fine particulate matter (PM2.5) has been associated with an increased risk of chronic kidney disease (CKD), and exposure to PM2.5 is known to aggravate ischemia/reperfusion injury-induced acute kidney injury (AKI) in mice. The impact of PM2.5 concentration on the incidence of CKD, AKI, and glomerulopathy in the megacity of Sao Paulo is has never been described. We analyzed meteorological variables, PM2.5 concentrations, and hospital admissions in São Paulo, Brazil, from 2011 to 2021. Admissions were categorized by age and sex. We analyzed 37,170 records, 55% representing males. Exposure to PM2.5 was found to increase CKD hospitalization risk by 1–4 times (95% CI: 1.009–1.18), across different age groups and exposure levels. Long-term exposure to a high PM2.5 concentration (65 μg/m3) increases that risk considerably for individuals aged 19–50 years (relative risk [RR]: 1.01; 95% CI: 1.005–1.015 and RR: 1.013; 95% CI: 1.01–1.018, respectively), the risk being ≤ 2.5 times higher in men aged 51–75 years (RR: 1.025; 95% CI: 1.015–1.032). The AKI hospitalization risk after prolonged exposure to high PM2.5 concentrations was highest for men aged 19–50 years (RR: 1.04; 95% CI: 1.012–1.07). The risk of glomerulopathy was highest in the < 40-year age group, especially among men exposed to concentrations of 15 μg/m3 (RR: 1.02; 95% CI: 1.007–1.025) and 65 μg/m3 (RR: 1.07; 95% CI: 1.02–1.11). Such exposure also increased the cumulative risk of hospitalization for membranous nephropathy, regardless of sex and age. Our findings underscore the urgent need to develop global strategies for air pollution reduction.
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Data availability
The datasets analyzed in this study are available online: https://github.com/iaradasilva/supplementary-data/tree/main).
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Funding
This work was supported by a joint consortium grant on healthy aging (www.pmkidney.com) from the Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO, Dutch Research Council) and the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, São Paulo Research Foundation; Grant nos. 2019/19433–0 and 2016/18438–0). IS, EDF, LA, and MFA are the recipients of grants from the Brazilian Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development; Grant nos. 140512/2021–7, 313210/2022–5, 309683/2021–1, and 306849/2007–0, respectively). CFHW is financially supported by the São Paulo Research Foundation (FAPESP), Brasil (Grants #2020/07674–0 and #2022/13888–9).AT is financially supported by the NWO–FAPESP joint grant on healthy aging, executed by the ZorgOnderzoek Nederland/Medische Wetenschappen (ZonMw, Netherlands Healthcare Research/Medical Sciences; Grant no. 457002002) and Junior Kolff grant from the Dutch kidney Foundation.
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IDS and LA performed the data analysis; IDS, MEGC, ADP, IS, CFHW, JJTHR, SF, TRS, EDF, JK, AT, MFA and LA wrote the main manuscript text and IDS and TRS prepared Figs. 1, 2, 3, 4, 5, 6, 7, 8. All authors reviewed the manuscript.
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Da Silva, I., Calderón, M.E.G., Peralta, A.D. et al. Chronic PM2.5 exposure and increased risk of hospitalization for kidney disease in São Paulo, Brazil. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39558-5
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DOI: https://doi.org/10.1038/s41598-026-39558-5
