Wu Chun-Yi, Hsu Chia-Tien, Chung Mu-Chi, Chen Cheng-Hsu, Wu Ming-Ju
Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Nursing, Asia University, Taichung, Taiwan.
J Multidiscip Healthc. 2022 Aug 31;15:1901-1908. doi: 10.2147/JMDH.S371815. eCollection 2022.
Air pollution is a novel environmental risk factor for chronic kidney disease (CKD). Air quality improved during COVID-19 lockdowns; however, the effects of these lockdowns on PM concentrations and renal function remain unclear.
We conducted a retrospective cohort study to compare air pollution and estimated glomerular filtration rate (eGFR) decline in patients with stage 5 CKD between a year-long period of lockdown (2020; n = 724) and a similar period before lockdown (2019, n = 758).
Compared with 2019, a 17.5% reduction in the average PM concentration (from 17.36% to 14.32%; < 0.001) and a 45.1% reduction (from 20.56% to 11.25%; < 0.001) in cumulative days with PM concentration >35 μg/m were noted in 2020. Moreover, a 93% reduction in PM air quality index >150 per station-day (from 0.43% to 0.03%) was observed in 2020. From 2019 to 2020, the yearly incidence of eGFR decline ≥5 mL/min/1.73 m decreased by 33.7% (24.6% vs 16.3%; < 0.001). Similarly, the proportion of patients who started undergoing regular dialysis also decreased by 32.7% in 2020 (from 20.8% to 14.0%; = 0.001).
Our findings suggest that fewer events of renal function decline during the COVID-19 pandemic may be associated with a decline in PM concentrations, supporting the global strategy of reducing air pollution to prevent CKD progression.
空气污染是慢性肾脏病（CKD）一种新的环境风险因素。在新冠疫情封锁期间空气质量有所改善；然而，这些封锁措施对颗粒物浓度和肾功能的影响仍不明确。
我们进行了一项回顾性队列研究，比较了5期CKD患者在长达一年的封锁期（2020年；n = 724）和封锁前类似时期（2019年，n = 758）的空气污染情况以及估算肾小球滤过率（eGFR）下降情况。
与2019年相比，2020年平均颗粒物浓度降低了17.5%（从17.36%降至14.32%；P < 0.001），颗粒物浓度>35 μg/m³的累积天数减少了45.1%（从20.56%降至11.25%；P < 0.001）。此外，2020年每个站点日颗粒物空气质量指数>150的情况减少了93%（从0.43%降至0.03%）。从2019年到2020年，eGFR下降≥5 mL/min/1.73 m²的年发病率下降了33.7%（24.6%对16.3%；P < 0.001）。同样，2020年开始接受规律透析的患者比例也下降了32.7%（从20.8%降至14.0%；P = 0.001）。
我们的研究结果表明，新冠疫情期间肾功能下降事件减少可能与颗粒物浓度降低有关，支持了减少空气污染以预防CKD进展的全球战略。
