Nagai Kei, Araki Shin, Sairenchi Toshimi, Ueda Kayo, Yamagishi Kazumasa, Shima Masayuki, Yamamoto Kouhei, Iso Hiroyasu, Irie Fujiko
Department of Nephrology, Hitachi General Hospital, Hitachi, Japan.
Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
JMA J. 2024 Jul 16;7(3):334-341. doi: 10.31662/jmaj.2024-0032. Epub 2024 Jun 3.
Global health hazards caused by air pollution, such as chronic kidney disease (CKD), have been gaining attention; however, air pollution-associated CKD has not been explored in Japan.
We examined 77,770 men and women with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m in the Ibaraki Prefecture who participated in annual community-based health checkups from 1993 at 40-75 years old and were followed up through December 2020. The outcome was newly developed kidney dysfunction with eGFR of <60 ml/min/1.73 m during follow-up. To assess air pollution, a PM exposure model was employed to estimate yearly means at 1 × 1-km resolution, converted into means at the municipal level. Hazard modeling was employed to examine PM concentrations in residential areas as a risk factor for outcomes.
Participants were distributed across 23 municipalities in the Ibaraki Prefecture, with PM concentrations between 16.2 and 33.4 μg/m (mean, 22.7 μg/m) in 1987-1995 as the exposure period. There were 942 newly developed kidney dysfunctions during follow-up. Based on 1987-1995 PM concentrations as the baseline exposure, the multivariate-adjusted hazard ratio per 10-μg/m increase in PM for newly developed kidney dysfunction was 1.02 (95%CI, 0.80-1.24) in men and 1.19 (95%CI, 0.95-1.44) in women.
Elevated PM did not represent a significant risk factor for incident CKD in a prefecture in Japan.
空气污染造成的全球健康危害，如慢性肾脏病（CKD），已受到关注；然而，在日本尚未对空气污染相关的慢性肾脏病进行研究。
我们调查了茨城县77770名估计肾小球滤过率（eGFR）≥60 ml/min/1.73 m²的男性和女性，他们于1993年参加了社区年度健康检查，年龄在40 - 75岁之间，并随访至2020年12月。研究结局为随访期间新出现的肾功能不全，eGFR <60 ml/min/1.73 m²。为评估空气污染，采用颗粒物暴露模型以1×1公里分辨率估算年均值，并转换为市级均值。采用风险建模来研究居民区颗粒物浓度作为结局的风险因素。
参与者分布在茨城县的23个市，1987 - 1995年暴露期间的颗粒物浓度在16.2至33.4 μg/m³之间（均值为22.7 μg/m³）。随访期间有942例新出现的肾功能不全。以1987 - 1995年颗粒物浓度作为基线暴露，颗粒物每增加10 μg/m³，新出现肾功能不全的多因素调整风险比在男性中为1.02（95%CI，0.80 - 1.24），在女性中为1.19（95%CI，0.95 - 1.44）。
在日本一个县，颗粒物升高并非新发慢性肾脏病的显著风险因素。
