TY - JOUR
T1 - Exposure to ambient air pollutants with kidney function decline in chronic kidney disease patients
AU - Chang, Po Ya
AU - Li, Yu Ling
AU - Chuang, Ting Wu
AU - Chen, Szu Ying
AU - Lin, Li Yin
AU - Lin, Yuh Feng
AU - Chiou, Hung Yi
N1 - Funding Information:
This study was supported by the Health Promotion Administration, Ministry of Health and Welfare, Taiwan, Republic of China (DOH101-HP-1103, DOH102-HP-1103, MOHW103-HPA-H-114-134101, MOHW104-HPA-H-114-134101).
Funding Information:
This study was supported by the Health Promotion Administration, Ministry of Health and Welfare , Taiwan, Republic of China ( DOH101-HP-1103 , DOH102-HP-1103 , MOHW103-HPA-H-114-134101 , MOHW104-HPA-H-114-134101 ).
Publisher Copyright:
© 2022
PY - 2022/12
Y1 - 2022/12
N2 - Chronic kidney disease (CKD) has been a global public health problem with many adverse outcomes, but data are lacking regarding the relationship between air pollutants and risk of renal progression in patients with CKD. This study was to investigate whether 1-year average exposure to ambient air pollutants –CO, NO, NO2, SO2, O3, PM2.5, and PM10—is related to renal function deterioration among patients with CKD. A total of 5301 CKD patients were included in this study between October 2008 and February 2016. To estimate each patient's exposure to ambient air pollution, we used the 24-h ambient air pollution concentration monitoring data collected one year prior to renal progression or their last renal function assessment. Renal progression was considered when estimated glomerular filtration rate (eGFR) decreased more than 25% from the baseline eGFR. Cox proportional hazard regression was performed to calculate hazard ratios (HRs). Among 5301 patients with CKD, 1813 (34.20%) developed renal progression during the 30.48 ± 14.99-month follow-up. Patients with the highest quartile exposure to CO [HR = 1.53 (95% CI: 1.24, 1.88)], NO [HR = 1.38 (95% CI: 1.11, 1.71)], NO2 [HR = 1.63 (95% CI: 1.36, 1.97)], SO2 [HR = 2.27 (95% CI: 1.83, 2.82)], PM2.5 [HR = 7.58 (95% CI: 5.97, 9.62)], and PM10 [HR = 3.68 (95% CI: 2.84, 4.78)] had a significantly higher risk of renal progression than those with the lowest quartile exposure. In the multipollutant model, the analyses yielded to similar results. These results reinforce the importance of measures to mitigate air pollution and strategies to prevent worsening of kidney function in patients with CKD. One-year high exposure to ambient CO, NO, NO2, SO2, PM2.5, and PM10 is significantly associated with deteriorated kidney function in patients with CKD among Taiwanese adults.
AB - Chronic kidney disease (CKD) has been a global public health problem with many adverse outcomes, but data are lacking regarding the relationship between air pollutants and risk of renal progression in patients with CKD. This study was to investigate whether 1-year average exposure to ambient air pollutants –CO, NO, NO2, SO2, O3, PM2.5, and PM10—is related to renal function deterioration among patients with CKD. A total of 5301 CKD patients were included in this study between October 2008 and February 2016. To estimate each patient's exposure to ambient air pollution, we used the 24-h ambient air pollution concentration monitoring data collected one year prior to renal progression or their last renal function assessment. Renal progression was considered when estimated glomerular filtration rate (eGFR) decreased more than 25% from the baseline eGFR. Cox proportional hazard regression was performed to calculate hazard ratios (HRs). Among 5301 patients with CKD, 1813 (34.20%) developed renal progression during the 30.48 ± 14.99-month follow-up. Patients with the highest quartile exposure to CO [HR = 1.53 (95% CI: 1.24, 1.88)], NO [HR = 1.38 (95% CI: 1.11, 1.71)], NO2 [HR = 1.63 (95% CI: 1.36, 1.97)], SO2 [HR = 2.27 (95% CI: 1.83, 2.82)], PM2.5 [HR = 7.58 (95% CI: 5.97, 9.62)], and PM10 [HR = 3.68 (95% CI: 2.84, 4.78)] had a significantly higher risk of renal progression than those with the lowest quartile exposure. In the multipollutant model, the analyses yielded to similar results. These results reinforce the importance of measures to mitigate air pollution and strategies to prevent worsening of kidney function in patients with CKD. One-year high exposure to ambient CO, NO, NO2, SO2, PM2.5, and PM10 is significantly associated with deteriorated kidney function in patients with CKD among Taiwanese adults.
KW - Chronic kidney disease
KW - Gaseous pollutant
KW - Multicenter studies
KW - Ordinary kriging
KW - Particulate matter
KW - Renal progression
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UR - http://www.scopus.com/inward/citedby.url?scp=85138214258&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2022.114289
DO - 10.1016/j.envres.2022.114289
M3 - Article
C2 - 36116493
AN - SCOPUS:85138214258
SN - 0013-9351
VL - 215
JO - Environmental Research
JF - Environmental Research
M1 - 114289
ER -
