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.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
Environ Pollut. 2020 Jun;261:114154. doi: 10.1016/j.envpol.2020.114154. Epub 2020 Feb 14.
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.
空气污染物已被报道为慢性肾脏病（CKD）的一个可能危险因素。然而，关于酸性气体和 CKD 的流行病学结果仍有待阐明。我们将台湾空气质量监测数据库（TAQMD）与纵向健康保险数据库相关联。建立了一个由 161970 名未被诊断为 CKD 的台湾公民组成的观察性队列。根据四分位数，将空气污染物浓度分为四个水平。多变量和单变量 Cox 比例风险回归模型用于评估发展为 CKD 和终末期肾病（ESRD）的风险。与 Q1 水平的 SO2 相比，暴露于 Q4 水平时，发展 CKD 的风险增加 1.46 倍（95%置信区间 [CI] = 1.28-1.65），发展 ESRD 的风险增加 1.32 倍（95% CI = 1.03-1.70）。与 Q1 水平的 NOx 相比，暴露于 Q4 水平时，发展 CKD 的风险增加 1.39 倍（95% CI = 1.22-1.58），发展 ESRD 的风险增加 1.70 倍（95% CI = 1.33-2.18）。与 Q1 水平的 NO 相比，暴露于 Q4 水平时，发展 CKD 的风险增加 1.48 倍（95% CI = 1.30-1.68），发展 ESRD 的风险增加 1.54 倍（95% CI = 1.20-1.98）。与 Q1 水平的<2.5 μm（PM2.5）颗粒相比，暴露于 Q4 水平时，发展 CKD 的风险增加 1.74 倍（95% CI = 1.53-1.98），发展 ESRD 的风险增加 1.69 倍（95% CI = 1.32-2.16）。暴露于颗粒物质和酸性气体空气污染与 CKD 和 ESRD 风险增加相关。
