Objectives: Itiswellknownthatlong-termexposuretoparticulatematterlessthan10μmisassociatedwithadversekidneydisease,includingchronickidneydiseaseandend stagerenaldisease(ESRD).Autosomaldominantpolycystickidneydisease(ADPKD)isawell-knowncauseofESRD.However,therelationshipbetweenparticulatematterandADPKDisunknown. Methods: Wecollected937ADPKDpatientsinSNUHbetween2010and2020.Theassociationbetweenthelong-termexposuretoPM10andmortalityconfirmedbyKoreaNationalStatisticalOfficewasestimatedinCoxproportionalhazardmodeladjustedbytotalkidneyvolume,sex,age,hemoglobin,albumin,whitebloodcell,bloodureanitrogen,andestimatedglomerularfiltrationrate. Results: Duringthe6.4yearsofaveragefollow-up,10deaths(1%)occurred.TheaverageexposuretoPM10was47.9μg/m3for1-year,48.5μg/m3for2-year,49.2μg/m3for3-year,and49.8μg/m3for4-year.Wefoundasignificantlong-termrelationshipbetweenmortalityriskandincreaseofPM10for1-year(HR1.15,95%CI1.00-1.32), 2-year(HR1.22,95%CI1.05-1.42),3-year(HR1.28,95%CI1.09-1.51),and4-year(HR1.32,95%CI1.11-1.57). Conclusions: Long-termexposuretoparticulatematterswasassociatedwithincreasedriskofmortalityinpatientswithADPKD.