Associations between water quality measures and chronic kidney disease prevalence in Taiwan

Kuan Y. Chang, I. Wen Wu, Bo Ruei Huang, Jih Gau Juang, Jia Chyi Wu, Su Wei Chang, Chung Cheng Chang

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


To determine the relationships between exposure to environmental contaminants in water and chronic kidney disease (CKD), we investigated the associations of 61 water attributes with the prevalence of CKD and End-Stage Renal Disease (ESRD) using data from 2005 to 2011 from all 22 counties and cities in the main island of Taiwan. We acquired patient information from the Taiwan Longitudinal Health Insurance Database to calculate the age-standardized CKD and ESRD prevalence rates and linked the patients’ residences to the water quality monitoring data, which were sampled periodically for a total of over 45,000 observations obtained from the Taiwan Environmental Water Quality Information Database. The association analysis adjusting for gender, age, and annual effects showed that the zinc (Zn), ammonia, chemical oxygen demand (COD), and dissolved oxygen in rivers were weakly correlated with CKD (τ = 0.268/0.250/0.238/−0.267, p = 6.01×10−6/2.52×10−5/6.05×10−5/3.30×10−5, respectively), but none for ESRD. The importances of Zn and COD in rivers were also demonstrated in a CKD regression model. Moreover, an unusually high CKD prevalence was related to arsenic contamination in groundwater. A further prospective cohort study would improve our understanding of what level of environmental water with risky properties could affect the development of CKD.

Original languageEnglish
Article number2726
JournalInternational journal of environmental research and public health
Issue number12
Publication statusPublished - Dec 2018
Externally publishedYes


  • Ammonia
  • Arsenic
  • Chemical oxygen demand
  • Chronic kidney disease
  • Dissolved oxygen
  • End-stage renal disease
  • Water contaminants
  • Zinc

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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