Session Name: Kidney Psychosocial
Session Date & Time: None. Available on demand.
*Purpose: Although cognitive function among kidney failure patients improves after kidney transplant (KT), cognitive impairment is common and associated with worse post-KT outcomes. Particulate matter (PM2.5), a common type of air pollution, is associated with dementia among general population; less is known about this effect among KT recipients. In this study, we seek to investigate the association between PM2.5 and post-KT cognitive function trajectory among KT recipients.
*Methods: We measured global cognitive function (3MS) among 637 KT recipients from a two-center, prospective cohort. We obtained the PM2.5 data from NASA’s Socioeconomic Data and Application Center Global Annual PM2.5 Grids and linked the data to the participants using personal address and year of KT. The association between PM2.5 and cognitive change post-KT was investigated using mixed model with random slope (time) and intercept (person) adjusting for age, sex, race/ethnicity, education and cognitive score prior to KT. We also explored the association separately by smoking status.
*Results: Among 637 KT recipients, the median age at KT was 54.4 (IQR 43.1-64.0), 60.4% were male and 50.2% were non-Hispanic white. The median PM2.5 exposure level was 10.1 µg/m3 (IQR 9.4-11.1 µg/m3). After adjustment, higher level of PM2.5 exposure was not associated with steeper cognitive decline among KT recipients (Table 1). However, among ever smokers, those who had the 2nd (9.4-10.1 µg/m3; slope=-1.34 points/year; pinteraction=0.003), 3rd (10.2-11.2µg/m3; slope=-0.47 points/year; pinteraction=0.048) and 4th (11.2-16.5 µg/m3; slope=-1.01 points/year; pinteraction=0.006) quartile of PM2.5 exposure had steeper decline in cognitive function compared to those who had lowest quartile of PM2.5 exposure (1.2-9.3 µg/m3; slope=1.24 points/year).
*Conclusions: Exposure to higher level of PM2.5 was associated with steeper cognitive decline among KT recipients who were ever smokers, but not the overall study population. Our results suggested that air pollution might contribute to cognitive decline among some subgroups of KT recipients. Clinicians should consider performing cognitive screening tests for all transplant recipients who have a history of smoking and live in an area with high air pollution.
|Quartile1 (1.2-9.3)||Quartile 2 (9.4-10.1)||Quartile 3 (10.2-11.1)||Quartile 4 (11.2-16.5)|
|Overall||Annual change in 3MS score (95%CI)||0.35 (-0.28, 0.97)||-0.11 (-0.64, 0.42)||-0.17 (-0.71, 0.37)||-0.31 (-0.78, 0.17)|
|Ever Smoker||Annual change in 3MS score (95%CI)||1.24 (-0.06, 2.55)||-1.34 (-2.50, -0.19)||-0.47 (-1.56, 0.61)||-1.01 (-1.93, -0.09)|
|Never Smoker||Annual change in 3MS score (95%CI)||0.05 (-0.60, 0.70)||0.04 (-0.51, 0.59)||-0.13 (-0.73, 0.47)||0.07 (-0.46, 0.61)|
To cite this abstract in AMA style:Feng Y, Jones M, Chu N, Segev D, Demarco MMcAdams. Ambient Air Pollution and Changes in Cognitive Function Among Kidney Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/ambient-air-pollution-and-changes-in-cognitive-function-among-kidney-transplant-recipients/. Accessed June 20, 2021.
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