WCN26-3811 MODELLING THE PROJECTED CLINICAL AND ENVIRONMENTAL BURDEN OF CHRONIC KIDNEY DISEASE IN EGYPT AND MOROCCO BETWEEN 2025 AND 2030

Introduction: Fine particulate matter (PM2.5) is one of the modifiable environmental risk factors and has been linked to cardiovascular diseases, chronic kidney disease, and metabolic dysregulation.Recently, the concept of the cardiovascular-kidney-metabolic (CKM) syndrome has emerged, highlighting the inter connections driven by obesity and metabolic dysfunction that contribute to progressive heart and kidney injury.However, epidemiological evidence regarding the relationship between long-term PM2.5 exposure and the development or progression of CKM syndrome remains limited.Methods: We conducted a retrospective cohort study using data from 332,266 adults enrolled in the MJ Health Database who completed health examinations between 2000 and 2017.Long-term exposure to fine particulate matter (PM 2 .5 ) was assessed using a high-resolution satellite-based spatiotemporal model derived from NASA's aerosol optical depth data.For each participant, the two-year average PM 2 .5 concentration preceding the health examination was used as an indicator of chronic exposure.Mortality outcomes were ascertained through linkage with the Taiwan Cause of Death Database, with followup extending to 2023.Multivariable Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders, including age, sex, educational attainment, smoking status, alcohol consumption, physical activity, hypertension, diabetes, and triglyceride levels.Results: Among a total of 332,266 participants, higher long-term exposure to ambient PM2.5 was associated with an increased risk of CKM syndrome and all-cause mortality.Each 10 g/m 3 increment in PM2.5 concentration was associated with a 2.4% higher likelihood of CKM syndrome (OR: 1.024, 95% CI: 1.006-1.043,P = 0.0097).Among participants with CKM syndrome, higher PM2.5 exposure was associated with a graded increase in mortality risk.Compared with the <25 WCN'26, YOKOHAMA, JAPAN