Long-Term Exposure to Fine Particulate Matter and the Deterioration of Estimated Glomerular Filtration Rate: A Cohort Study in Patients With Pre-End-Stage Renal Disease

Frontiers in Public Health

Chih-Da Wu¹  Chi-Jung Chung³  Laing-You Wu⁴  Hui-Tsung Hsu⁴  Cheng-Hsu Chen⁵  Mu-Chi Chung⁷  Yu-Hsien Wu⁸ 

[1] Adjunct Associate Research Fellow, National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan;Department of Geomatics, National Cheng Kung University, Tainan, Taiwan;Department of Medical Research, China Medical University Hospital, Taichung, Taiwan;Department of Public Health, China Medical University, Taichung, Taiwan;Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan;Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan;School of Medicine, China Medical University, Taichung, Taiwan;

关键词: PM2.5;    NO2;    land-use regression model;    eGFR;    pre-ESRD;   

DOI  :  10.3389/fpubh.2022.858655

来源: DOAJ

【 摘 要 】

Limited literature has explored the effect of air pollutants on chronic kidney disease (CKD) progression, especially for patients with pre-end-stage renal disease (pre-ESRD). In this study, we reported the linear and nonlinear relationships of air pollutants of particles with diameter <2.5 μm (PM2.5) and nitrogen dioxide (NO2) with estimated glomerular filtration rate (eGFR) deterioration after adjusting for smoking status and other traditional clinical factors. This study adopted a retrospective cohort of patients with stage 3b to stage 5 CKD (N = 11,479) from Taichung Veterans General Hospital during January 2006 to December 2020. The eGFR deterioration was defined as a decline in eGFR > 5 ml/min/1.73 m2/year. Hybrid kriging/land-use regression models were used to estimate the individual exposure levels of PM2.5 and NO2. The relationships of air pollutants with eGFR deterioration were evaluated using Cox proportional hazard models. After adjusting for smoking status, baseline eGFR stages, and other traditional clinical factors, the risk of eGFR deterioration was found to increase with increasing PM2.5 and NO2 level (p < 0.0001 and p = 0.041, respectively), especially for those exposed to PM2.5 ≥ 31.44 μg/m3 or NO2 ≥ 15.00 ppb. Similar results were also found in the two-pollutant models. Nonlinear dose–response relationships of eGFR deterioration were observed for concentrations of 26.11 μg/m3 for PM2.5 and 15.06 ppb for NO2. In conclusion, linear and nonlinear associations between PM2.5 and NO2 levels and the incidence risk of eGFR deterioration were observed in patients with pre-ESRD.

【 授权许可】

Unknown