Air pollutants and subsequent risk of chronic kidney disease and end-stage renal disease: A population-based cohort study

Shih-Yi Lin; Shu-Woei Ju; Cheng Li Lin; Wu-Huei Hsu; Cheng-Chieh Lin; I-Wen Ting; Chia-Hung Kao

doi:10.1016/j.envpol.2020.114154

Air pollutants and subsequent risk of chronic kidney disease and end-stage renal disease: A population-based cohort study

Environ Pollut. 2020 Jun:261:114154. doi: 10.1016/j.envpol.2020.114154. Epub 2020 Feb 14.

Authors

Shih-Yi Lin¹, Shu-Woei Ju¹, Cheng Li Lin², Wu-Huei Hsu³, Cheng-Chieh Lin⁴, I-Wen Ting¹, Chia-Hung Kao⁵

Affiliations

¹ Graduate Institute of Biomedical Sciences, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.
² Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
³ Graduate Institute of Biomedical Sciences, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan.
⁴ Graduate Institute of Biomedical Sciences, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
⁵ Graduate Institute of Biomedical Sciences, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, And Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan; Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

PMID: 32088432
DOI: 10.1016/j.envpol.2020.114154

Abstract

Air pollutants have been reported to be a possible risk factor of chronic kidney disease (CKD). However, epidemiologic results regarding acidic gases and CKD have yet to be elucidated. We linked the Taiwan Air Quality Monitoring Database (TAQMD) to the Longitudinal Health Insurance Database. An observational cohort of 161,970 Taiwan citizens who had not been diagnosed with CKD was formed. The concentrations of air pollutant were classified into four levels based on quartile. Multivariable and univariable Cox proportional hazard regression models were used to assess the risk of developing CKD and end-stage renal disease (ESRD). Compared with Q1-level SO2, exposure to the Q4 level was at a 1.46-fold risk of developing CKD (95% confidence interval [CI] = 1.28-1.65) and 1.32-fold risk of ESRD (95% CI = 1.03-1.70). Compared with Q1-level NOx, exposure to the Q4 level was at a 1.39-fold higher risk of developing CKD (95% CI = 1.22-1.58) and 1.70-fold risk of ESRD (95% CI = 1.33-2.18). Compared with Q1-level NO, exposure to the Q4 level was at a 1.48-fold risk of CKD (95% CI = 1.30-1.68) and 1.54-fold risk of ESRD (95% CI = 1.20-1.98). Compared with Q1-level particles <2.5 μm (PM2.5), exposure to the Q4 level were at a 1.74-fold risk of CKD (95% CI = 1.53-1.98) and 1.69-fold risk of ESRD (95% CI = 1.32-2.16). Exposure to particulate and acidic gas air pollution was observed to be associated with an increased risk of CKD and ESRD.

Keywords: Acidic gases; Air pollution; Chronic kidney disease; Taiwan air quality monitoring database.

Publication types

Observational Study

MeSH terms

Air Pollutants / analysis*
Cohort Studies
Humans
Kidney Failure, Chronic*
Particulate Matter / analysis
Renal Insufficiency, Chronic*
Risk Factors
Taiwan

Substances

Air Pollutants
Particulate Matter