After fully adjusting for covariates, including sex, age of DM onset, duration of diabetes, hyperlipidemia, using of lipid-lowering drugs, smoking, insulin treatment, HF, baseline eGFR, MAP, BMI, anemia, urinary protein, and serum ALB, a positive relationship was found between five types of air pollutants (PM2.5, PM10, CO, NO2, and SO2) and the risk of ESRD, while O3 showed no significant association (Fig. 4). Here, INS is linked to anemia.