Table 2.

Associations of ambient fine particulate matter (PM_2.5) with diabetes and kidney disease outcomes, and of diabetes and kidney disease outcomes.

The association of ambient fine particulate matter (PM2.5) with diabetes
Exposure		Diabetes*
		ICD-9 only OR (CI)		Medication** OR (CI)
PM2.5+		1.18 (1.06-1.32)		1.22 (1.07-1.39)
The association of ambient fine particulate matter (PM2.5) with kidney disease outcomes
Exposure		Incident eGFR Less Than 60 ml/min/1.73 m2 HR (CI)	Incident CKD HR (CI)	≥30% Decline in eGFR HR (CI)	ESRD or ≥50% Decline in eGFR HR (CI)
PM2.5+		1.20 (1.13-1.29)	1.28 (1.18-1.39)	1.23 (1.15-1.33)	1.17 (1.05-1.30)
The association of diabetes with kidney disease outcomes
Exposure		Incident eGFR Less Than 60 ml/min/1.73 m2 HR (CI)	Incident CKD HR (CI)	≥30% Decline in eGFR HR (CI)	ESRD or ≥50% Decline in eGFR HR (CI)
Diabetes*	ICD-9 only	1.21 (1.20-1.23)	1.31 (1.29-1.33)	1.26 (1.24-1.27)	1.41 (1.38-1.44)
	Medication**	1.58 (1.56-1.59)	1.84 (1.82-1.86)	1.68 (1.67-1.70)	2.06 (2.02-2.10)
Proportion of the association between PM2.5 and kidney disease mediated by diabetes
Exposure		Incident eGFR Less Than 60 ml/min/1.73 m2 % (CI)	Incident CKD % (CI)	≥30% Decline in eGFR % (CI)	ESRD or ≥50% Decline in eGFR % (CI)
PM2.5		4.7 (4.3-5.7)	4.8 (4.2-5.8)	5.8 (5.0-7.0)	17.0 (13.1-20.4)

Models adjusted for age, race, gender, cancer, cardiovascular disease, chronic lung disease, hyperlipidemia, T₀ eGFR, body mass index, smoking status, ACEI/ARB use, systolic blood pressure, diastolic blood pressure, number of outpatient eGFR measurements, number of hospitalizations, county population density, and county percent in poverty.

⁺For every 10 μg/m³ increase in PM_2.5

*No diabetes served as the reference category.

**Defined by intake of oral hypoglycemic agents or insulin.

Abbreviations: PM_2.5, ambient particulate matter <2.5 µm in aerodynamic diameter; eGFR, estimated glomerular filtration rate; CKD, Chronic Kidney Disease; ESRD, end stage renal disease; CI, 95% confidence interval.