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County-level air quality and the prevalence of diagnosed chronic kidney disease in the US Medicare population

Author

Listed:
  • Jennifer Bragg-Gresham
  • Hal Morgenstern
  • William McClellan
  • Sharon Saydah
  • Meda Pavkov
  • Desmond Williams
  • Neil Powe
  • Delphine Tuot
  • Raymond Hsu
  • Rajiv Saran
  • for the Centers for Disease Control and Prevention CKD Surveillance System

Abstract

Background: Considerable geographic variation exists in the prevalence of chronic kidney disease across the United States. While some of this variability can be explained by differences in patient-level risk factors, substantial variability still exists. We hypothesize this may be due to understudied environmental exposures such as air pollution. Methods: Using data on 1.1 million persons from the 2010 5% Medicare sample and Environmental Protection Agency air-quality measures, we examined the association between county-level particulate matter ≤2.5 μm (PM2.5) and the prevalence of diagnosed CKD, based on claims. Modified Poisson regression was used to estimate associations (prevalence ratios [PR]) between county PM2.5 concentration and individual-level diagnosis of CKD, adjusting for age, sex, race/ethnicity, hypertension, diabetes, and urban/rural status. Results: Prevalence of diagnosed CKD ranged from 0% to 60% by county (median = 16%). As a continuous variable, PM2.5 concentration shows adjusted PR of diagnosed CKD = 1.03 (95% CI: 1.02–1.05; p

Suggested Citation

  • Jennifer Bragg-Gresham & Hal Morgenstern & William McClellan & Sharon Saydah & Meda Pavkov & Desmond Williams & Neil Powe & Delphine Tuot & Raymond Hsu & Rajiv Saran & for the Centers for Disease Cont, 2018. "County-level air quality and the prevalence of diagnosed chronic kidney disease in the US Medicare population," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-13, July.
    • Handle: RePEc:plo:pone00:0200612
    DOI: 10.1371/journal.pone.0200612
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    Cited by:

    1. Aloys Prinz & David J. Richter, 2021. "Feinstaubbelastung und Lebenserwartung in Deutschland," AStA Wirtschafts- und Sozialstatistisches Archiv, Springer;Deutsche Statistische Gesellschaft - German Statistical Society, vol. 15(3), pages 237-272, December.
    2. Joshua W. Schaeffer & John L. Adgate & Stephen J. Reynolds & Jaime Butler-Dawson & Lyndsay Krisher & Miranda Dally & Richard J. Johnson & Katherine A. James & Diana Jaramillo & Lee S. Newman, 2020. "A Pilot Study to Assess Inhalation Exposures among Sugarcane Workers in Guatemala: Implications for Chronic Kidney Disease of Unknown Origin," IJERPH, MDPI, vol. 17(16), pages 1-15, August.

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