Supplemental Table 1. Missing PM

Supplemental Material Table of Contents

Page No.

Supplemental Table 1. Missing PM

2.5

1

Supplemental Table 2. Excluded participants 1

Supplemental Table 3. Participants censored 1

Supplemental Table 4. Variable parameterization 2

Supplemental Table 5. Missing covariates 2

Supplemental Table 6. Heterogeneity of effect (I

²

) for associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD

3

Supplemental Table 7. Sensitivity analyses for associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD when omitting Jackson and testing 60- and 120-month PM

2.5

exposures

4

Supplemental Table 8. Heterogeneity of effect for associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD when excluding Jackson

5

Supplemental Table 9. CKD incidence in participants with estimated glomerular filtration rate

≥ 60 ml/min/1.73 m

²

at baseline by site, stratified by median annual average PM

2.5

6 Supplemental Table 10. Between and within site effects for Cox proportional hazards models

of annual average PM

2.5

and incident CKD 7

Supplemental Table 11. Sensitivity analyses for association of annual average PM

2.5

with

incident CKD when excluding those with urinary albumin to creatinine ratio ≥ 30 mg/g 8 Supplemental Table 12. Competing risk analysis for association of annual average PM

2.5

with

incident CKD with a competing risk of non-CKD death 9

Supplemental Table 13. Positive and negative control models for the associations of annual

average PM

2.5

with height, area deprivation index, incident cellulitis, and incident mortality 10 Supplemental Figure 1. Forest plots describing overall and site-specific associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD.

11

Supplemental Figure 2. Forest plots describing overall and site-specific associations of 60- month PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD.

12

Supplemental Figure 3. Forest plots describing overall and site-specific associations of 120- month PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD.

13

Supplemental Table 1. Missing PM

2.5

Exposure Number missing (%)

12-month PM2.5 476 (4.1) 60-month PM2.5 580 (5.0) 120-month PM2.5 635 (5.5) Missing any PM2.5 647 (5.6)

Supplemental Table 2. Excluded participants

Population Number

Population with visit 4 creatinine 11,560 Excluded incomplete annual PM2.5 exposure 476

Excluded ESRD at baseline 20

Excluded black in Minneapolis or Washington Co 37

Excluded non-white, non-black 30

Population in cross-sectional analyses 10,997 Excluded eGFR < 60 ml/min/1.73 m² at baseline 695 Population in CKD incidence analysis 10,302

Supplemental Table 3. Participants censored

Population Number

Total censored 4,780

Deceased 4,277

Lost to follow up 503

Supplemental Table 4. Variable parameterization

Variable Parameterization

Demographic

Sex Female vs non-female

Age Linear

Race Black vs non-black

Mean ambient temperature Linear Socioeconomic

Neighborhood socioeconomic score Linear

Annual family income < $5000, $5000-7999, $8000-11,999, $12,000-15,999, $16,000- 24,999, $25,000-34,999, $35,000-49,999, $50,000-74,999,

$75,000-99,999, ≥ $100,000 Education level ≤ 11 years, 12-16 years, 17-21 years Clinical

Body mass index Linear spline with knot at 30 kg/m²

Smoking status Never, former, current

Estimated glomerular filtration rate Linear

Urinary albumin to creatinine ratio Log-transformed C-reactive protein Log-transformed

Diabetes mellitus Yes vs no

Hypertension Yes vs no

Systolic blood pressure Linear spline with knot at 120 mm Hg Composite cardiovascular disease Yes vs no

Supplemental Table 5. Missing covariates

Covariate Number missing (%)

Female 0 (0.0)

Age 0 (0.0)

Black 0 (0.0)

Body mass index 20 (0.2)

Systolic blood pressure 2 (0.0)

Smoking status 60 (0.5)

Hypertension 44 (0.4)

Diabetes mellitus 47 (0.4)

Composite cardiovascular disease 0 (0.0) Estimated glomerular filtration rate 0 (0.0) Urinary albumin to creatinine ratio 98 (0.9)

C-reactive protein 215 (2.0)

Neighborhood socioeconomic index 245 (2.2)

Annual household income 495 (4.5)

Education level 17 (0.2)

Temperature 0 (0.0)

Supplemental Table 6. Heterogeneity of effect (I

²

) for associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD

eGFR I² (P value) UACR I² (P value) CKD I² (P value)

Model 1 58.4% (0.07) 64.1% (0.04) 0.0% (0.56)

Model 2 28.1% (0.24) 50.4% (0.11) 6.8% (0.36)

Model 1: sex, age, race, neighborhood socioeconomic score, family income, education level Model 2: Model 1 + BMI, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, eGFR,* UACR,** C-reactive protein, temperature Covariate omitted for eGFR analyses (*) and UACR analyses (**). Analyses performed per 1 µg/m³ higher PM2.5.

eGFR, estimated glomerular filtration rate; UACR, urinary albumin to creatinine ratio

Supplemental Table 7. Sensitivity analyses for associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD when omitting Jackson and testing 60- and 120-month PM

2.5

exposures

Cross-sectional model participants

eGFR, ml/min/1.73 m²

(95% CI) P value UACR, % difference (95% CI) P value Longitudinal model participants

Incident CKD, HR

(95% CI) P value Jackson omitted

Model 1 8829 -0.06 (-0.34 to 0.22) 0.69 10.5 (7.6 to 13.5) < 0.001 8282 1.07 (1.03 to 1.12) 0.001

Model 2 -0.03 (-0.32 to 0.25) 0.82 7.8 (5.1 to 10.6) < 0.001 1.05 (0.99 to 1.11) 0.08

60-month PM2.5

Model 1 10,893 -0.26 (-0.61 to 0.10) 0.16 4.7 (1.1 to 8.3) 0.009 10,206 1.06 (1.01 to 1.11) 0.03

Model 2 -0.28 (-6.4 to 0.08) 0.12 4.1 (0.5 to 7.7) 0.02 1.06 (0.98 to 1.14) 0.14

120-month PM2.5

Model 1 10,838 -0.24 (-0.61 to 0.12) 0.20 1.8 (-3.7 to 7.7) 0.53 10,151 1.02 (0.96 to 1.07) 0.58

Model 2 -0.27 (-0.64 to 0.10) 0.16 1.8 (-4.2 to 8.2) 0.56 1.01 (0.95 to 1.08) 0.77

Model 1: sex, age, race, neighborhood socioeconomic score, family income, education level.

Model 2: Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, eGFR,* UACR,**

C-reactive protein, temperature.

Covariate omitted for eGFR analyses (*) and UACR analyses (**). Analyses performed per 1 µg/m³ higher PM2.5. UACR coefficient exponentiated using the formula (e^β -1)*100%.

CI, confidence interval; eGFR, estimated glomerular filtration rate; HR, hazard ratio; PM2.5, particulate matter less than 2.5 µm in diameter; UACR, urinary albumin to creatinine ratio.

Supplemental Table 8. Heterogeneity of effect for associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD when excluding Jackson

eGFR I² (P value) UACR I² (P value) CKD I² (P value)

Model 1 0.0% (0.78) 0.0% (0.42) 0.0% (0.42)

Model 2 0.0% (0.87) 0.0% (0.45) 32.5% (0.23)

Model 1: sex, age, race, neighborhood socioeconomic score, family income, education level.

Model 2: Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, eGFR,* UACR,** C-reactive protein, temperature.

Covariate omitted for eGFR analyses (*) and UACR analyses (**). Analyses performed per 1 µg/m³ higher PM2.5.

eGFR, estimated glomerular filtration rate; UACR, urinary albumin to creatinine ratio.

Supplemental Table 9. CKD incidence in participants with estimated glomerular filtration rate ≥ 60 ml/min/1.73 m

²

at baseline by site, stratified by median annual average PM

2.5

Forsyth Co. Jackson Minneapolis Washington Co.

Overall 2527 2020 3015 2740

PM2.5 ≤ median 1263 1009 1504 1377

PM2.5 > median 1264 1011 1511 1363

Median years follow up

Overall 17.4 17.0 18.2 17.2

PM2.5 ≤ median 17.7 17.8 18.5 17.8

PM2.5 > median 17.2 16.4 18.1 16.6

Number of CKD events

Overall 642 625 734 815

PM2.5 ≤ median 328 311 358 402

PM2.5 > median 314 314 376 413

Number of CKD events diagnosed at visit

Overall 34 17 23 31

PM2.5 ≤ median 22 8 10 19

PM2.5 > median 12 9 13 12

Number of CKD events diagnosed by ICD code

Overall 608 608 711 784

PM2.5 ≤ median 306 303 348 383

PM2.5 > median 302 305 363 401

Person-years

Overall 38,869 30,366 47,322 41,641

PM2.5 ≤ median 20,029 15,647 23,833 21,476

PM2.5 > median 18,840 14,720 23,489 20,165

CKD incidence per 1000 person-years (95% CI)

Overall 16.5 (15.3 to 17.8) 20.6 (19.0 to 22.3) 15.5 (14.4 to 16.7) 19.6 (18.3 to 21.0)

PM2.5 ≤ median 16.4 (14.7 to 18.2) 19.9 (17.8 to 22.2) 15.0 (13.5 to 16.7) 18.7 (17.0 to 20.6) PM2.5 > median 16.7 (14.9 to 18.6) 21.3 (19.1 to 23.8) 16.0 (14.5 to 17.7) 20.5 (18.6 to 22.6)

Supplemental Table 10. Between and within site effects for Cox proportional hazards models of annual average PM

2.5

and incident CKD

Between site Cox model Between and within site Cox model Between site CKD HR (95% CI) 1.06 (1.02 to 1.11) 1.02 (0.99 to 1.04)

Within site CKD HR (95% CI) 1.05 (1.01 to 1.10)

Model 2 used for analysis: Model 1 (sex, age, race, neighborhood socioeconomic score, family income, education level) + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, estimated glomerular filtration rate, urinary albumin to creatinine ratio, C-reactive protein, temperature.

Analyses performed per 1 µg/m³ higher PM2.5. CI, confidence interval; HR, hazard ratio.

Supplemental Table 11. Sensitivity analyses for association of annual average PM

2.5

with incident CKD when excluding those with urinary albumin to creatinine ratio ≥ 30 mg/g

Longitudinal model participants Incident CKD, HR (95% CI) P value

Model 1 9496 1.06 (1.02 to 1.11) 0.006

Model 2 1.05 (1.01 to 1.10) 0.02

Model 1: sex, age, race, neighborhood socioeconomic score, family income, education level.

Model 2: Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, estimated glomerular filtration rate, UACR, C-reactive protein, temperature.

Analyses performed per 1 µg/m³ higher PM2.5.

eGFR, estimated glomerular filtration rate; UACR, urinary albumin to creatinine ratio.

Supplemental Table 12. Competing risk analysis for association of annual average PM

2.5

with incident CKD with a competing risk of non-CKD death

Incident CKD, HR (95% CI) P value

Model 1 1.04 (1.00* to 1.08) 0.045

Model 2 1.02 (0.98 to 1.07) 0.33

Model 1: sex, age, race, neighborhood socioeconomic score, family income, education level.

Model 2: Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, estimated glomerular filtration rate, urinary albumin to creatinine ratio, C-reactive protein, temperature.

Analyses performed per 1 µg/m³ higher PM2.5. Of 10,302 baseline participants at visit 4, 7450 and 6725 were alive at visits 5 and 6, respectively.

* Lower confidence interval of 1.001.

CI, confidence interval; HR, hazard ratio.

Supplemental Table 13. Positive and negative control models for the associations of annual average PM

2.5

with height, area deprivation index, incident cellulitis, and incident mortality

Negative controls Positive controls

Linear regression models Height (cm) P value Area deprivation index P value Model 1, change (95% CI) -0.02 (-0.16 to 0.12) 0.80 0.61 (0.04 to 1.18) 0.04 Model 2, change (95% CI) -0.03 (-0.20 to 0.14) 0.73 0.67 (0.11 to 1.23) 0.02 Cox proportional hazards models Cellulitis P value Mortality P value

Events (N) 659 4277

Model 1, HR (95% CI) 1.03 (0.90 to 1.17) 0.68 1.04 (1.01 to 1.08) 0.01 Model 2, HR (95% CI) 1.00 (0.88 to 1.13) 0.97 1.04 (1.00^§ to 1.07) 0.04 Model 1: sex, age, race, neighborhood socioeconomic score,* family income,* education level*.

Model 2: Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite cardiovascular disease, cigarette smoking, C-reactive protein, temperature.

Covariate omitted for area deprivation index analyses (*). Analyses performed per 1 µg/m³ higher PM2.5.

§ Lower confidence interval of 1.002.

CI, confidence interval; HR, hazard ratio.

Supplemental Figure 1. Forest plots describing overall and site-specific associations of annual average PM

2.5

with baseline estimated glomerular filtration rate, urinary albumin to creatinine ratio, and incident CKD. Model 1 includes sex, age, race, neighborhood

socioeconomic score, family income, education level. Model 2 includes Model 1 + body mass index, diabetes mellitus, hypertension, systolic

blood pressure, composite cardiovascular disease, cigarette smoking, eGFR,* UACR,** C-reactive protein, temperature. Covariate omitted for

eGFR analyses (*) and UACR analyses (**). Co, county; eGFR, estimated glomerular filtration rate; PM

2.5

, particulate matter less than 2.5 µm in

diameter; UACR, urinary albumin to creatinine ratio.

Supplemental Figure 2. Forest plots describing overall and site-specific associations of 60-month PM

2.5

with baseline estimated glomerular

filtration rate, urinary albumin to creatinine ratio, and incident CKD. Model 1 includes sex, age, race, neighborhood socioeconomic score,

family income, education level. Model 2 includes Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite

cardiovascular disease, cigarette smoking, eGFR,* UACR,** C-reactive protein, temperature. Covariate omitted for eGFR analyses (*) and UACR

analyses (**). Co, county; eGFR, estimated glomerular filtration rate; PM

2.5

, particulate matter less than 2.5 µm in diameter; UACR, urinary

albumin to creatinine ratio.

Supplemental Figure 3. Forest plots describing overall and site-specific associations of 120-month PM

2.5

with baseline estimated glomerular

filtration rate, urinary albumin to creatinine ratio, and incident CKD. Model 1 includes sex, age, race, neighborhood socioeconomic score,

family income, education level. Model 2 includes Model 1 + body mass index, diabetes mellitus, hypertension, systolic blood pressure, composite

cardiovascular disease, cigarette smoking, eGFR,* UACR,** C-reactive protein, temperature. Covariate omitted for eGFR analyses (*) and UACR

analyses (**). Co, county; eGFR, estimated glomerular filtration rate; PM

2.5

, particulate matter less than 2.5 µm in diameter; UACR, urinary

albumin to creatinine ratio.