Long-Term Effects of Air Pollutants on Mortality Risk in Patients with End-Stage Renal Disease

International Journal of Environmental Research and Public Health

Ejin Kim¹  Ho Kim¹  Jiyun Jung¹  JaeYoon Park²  Yong-Lim Kim³  JungPyo Lee⁴  YongChul Kim⁴  YonSu Kim⁴  Hyewon Lee⁵  Clinical Research Center for End-Stage Renal Disease (CRC for ESRD) Investigators⁶ 

[1] Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, Seoul 08826, Korea;Department of Internal Medicine, Dongguk University Ilsan Hospital, Gyeonggi-do 10326, Korea;Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu 41566, Korea;Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea;Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Korea;These authors are mentioned in Acknowledgments.;

关键词: particulate matter;    nitrogen dioxide;    sulfur dioxide;    esrd;    mortality;   

DOI  :  10.3390/ijerph17020546

来源: DOAJ

【 摘 要 】

Long-term exposure to air pollutants significantly increases the morbidity and mortality associated with various diseases. However, little is known about the relationship between air pollutants and end-stage renal disease (ESRD)-related mortality. A total of 5041 patients who started dialysis between 2008 and 2015 were prospectively enrolled in the Clinical Research Center for End-Stage Renal Disease (CRC-ESRD) cohort study. We assigned a daily mean concentration of air pollutants (PM₁₀, NO₂, and SO₂) to each participant. Time-varying Cox models were used to investigate the relationship between air pollutants and mortality in ESRD patients. During the follow-up period (mean 4.18 years), 1475 deaths occurred among 5041 participants. We found a significant long-term relationship between mortality risk and PM₁₀ (HR 1.33, CI 1.13−1.58), NO₂ (HR 1.46, CI 1.10−1.95), and SO₂ (HR 1.07, CI 1.03−1.11). Elderly patients and patients who lived in metropolitan areas had an increased risk associated with PM₁₀. Elderly patients also had increased risks associated NO₂ and SO₂. Long-term exposure to air pollutants had negative effects on mortality in ESRD patients. These effects were prominent in elderly patients who lived in metropolitan areas, suggesting that ambient air pollution, in addition to traditional risk factors, is important for the survival of these patients.

【 授权许可】

Unknown