Data Management and Statistics Institute, Dongguk University Ilsan Hospital, South Korea.
Department of Internal Medicine, Dongguk University Ilsan Hospital, South Korea; Department of Internal Medicine, Dongguk University College of Medicine, South Korea.
Sci Total Environ. 2021 Sep 10;786:147471. doi: 10.1016/j.scitotenv.2021.147471. Epub 2021 Apr 30.
Due to industrialization, the burden of diseases associated with air pollution is increasing. Although the risk associated with air pollution in the general population has been actively investigated, few studies have been conducted on the effects of exposure to air pollution in patients with chronic kidney disease (CKD) in East Asia. A total of 29,602 patients with CKD in Seoul participated in a retrospective cohort at three medical centers. We assessed the association of individualized exposure to five types of air pollutants (PM, PM, NO, SO, and CO) using inverse distance weighting (IDW) on mortality in CKD patients in the Cox proportional hazard model that was adjusted for sex, age, eGFR, hemoglobin, hypertension, diabetes, and area-level characteristics. During the 6.14 ± 3.96 years, 3863 deaths (13%) were observed. We confirmed the significant effects of PM (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.07-0.29) and CO (HR 1.17, 95% CI 1.00-1.38) on mortality in CKD patients. Different associations were found when stratified by age, body mass index, smoking, and drinking status. Long-term exposure to air pollutants had negative effects on mortality in patients with CKD. These effects were prominent in patients aged over 65 years, patients with a lean body, and those who did not drink alcohol.
由于工业化的发展，与空气污染相关的疾病负担正在增加。尽管人们已经积极研究了普通人群中空气污染的风险，但在东亚，针对慢性肾脏病（CKD）患者暴露于空气污染的影响的研究却很少。共有 29602 名 CKD 患者在三个医疗中心参与了一项回顾性队列研究。我们使用逆距离加权（IDW）评估了五种类型的空气污染物（PM、PM、NO、SO 和 CO）对 CKD 患者死亡率的个体暴露的相关性，在 Cox 比例风险模型中进行了调整，包括性别、年龄、eGFR、血红蛋白、高血压、糖尿病和地区特征。在 6.14±3.96 年期间，观察到 3863 例死亡（13%）。我们证实了 PM（危险比 [HR] 1.17，95%置信区间 [CI] 1.07-0.29）和 CO（HR 1.17，95% CI 1.00-1.38）对 CKD 患者死亡率的显著影响。当按年龄、体重指数、吸烟和饮酒状况分层时，发现了不同的关联。长期暴露于空气污染物对 CKD 患者的死亡率有负面影响。这些影响在年龄超过 65 岁的患者、瘦体型患者和不饮酒的患者中更为明显。
