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环境因素与慢性肾脏病:病例对照研究。

Environmental factors and chronic kidney disease: a case-control study.

机构信息

Neonatal and Children's Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Sci Rep. 2024 Nov 3;14(1):26511. doi: 10.1038/s41598-024-72685-5.

DOI:10.1038/s41598-024-72685-5
PMID:39489732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11532473/
Abstract

Chronic kidney disease (CKD) is a non-communicable disease that includes a range of different physiological disorders causing abnormal renal function and progressive decline in the glomerular filtration rate (GFR). This study aimed to investigate the associations of several Environmental factors with CKD in the Iranian population. This is the second phase of a hospital-based case-control study, which was conducted on 700 participants (350 CKD cases and 350 controls, age and gender frequency matched). Multiple logistic regression was applied to measure the associations between the selected factors and CKD. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. All p-values were two-sided and the results were considered statistically significant at p < 0.05. The results suggested that environmental factors including proximity of residence to mines (OR =3.98, 95%CI: 2.20-7.21, p < 0.001), proximity of residence to mobile antenna (OR =2.20, 95%CI: 1.24-3.89, p = 0.006), and exposure to chemicals (OR =4.40, 95%CI: 2.27-8.53, p < 0.001), were significantly associated with a higher risk of CKD. The present study covered a large number of factors in association with CKD and highlighted the importance of some environmental factors in development of CKD.‌ One of the main causes of heat in the work environment being a risk factor is dehydration caused by high heat. In order to reduce damage to the kidneys in jobs that deal with high heat, the following tips are recommended: drinking fluids, reducing working hours and shifts, proper ventilation in the workplace, using suitable clothes and heat protection.

摘要

慢性肾脏病(CKD)是非传染性疾病,包括一系列不同的生理紊乱,导致肾功能异常和肾小球滤过率(GFR)进行性下降。本研究旨在探讨伊朗人群中几种环境因素与 CKD 的关系。这是一项基于医院的病例对照研究的第二阶段,共纳入 700 名参与者(350 例 CKD 患者和 350 例对照,年龄和性别频率匹配)。采用多因素 logistic 回归分析评估所选因素与 CKD 的关系。计算比值比(OR)和 95%置信区间(CI)。所有 p 值均为双侧,p<0.05 时认为差异具有统计学意义。结果表明,环境因素包括居住地与矿山的距离(OR=3.98,95%CI:2.20-7.21,p<0.001)、居住地与移动天线的距离(OR=2.20,95%CI:1.24-3.89,p=0.006)和接触化学物质(OR=4.40,95%CI:2.27-8.53,p<0.001)与 CKD 的发生风险显著相关。本研究涵盖了与 CKD 相关的大量因素,并强调了一些环境因素在 CKD 发病机制中的重要性。工作环境中高温的一个主要原因是高温导致的脱水,这是一个危险因素。为了减少高温作业对肾脏的损害,建议采取以下措施:饮用液体、减少工作时间和轮班、工作场所适当通风、使用合适的衣服和热保护。

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本文引用的文献

1
Trend analysis and prediction of the incidence and mortality of CKD in China and the US.中国和美国慢性肾脏病发病率和死亡率的趋势分析和预测。
BMC Nephrol. 2024 Mar 1;25(1):76. doi: 10.1186/s12882-024-03518-w.
2
Environmental risk factors for reduced kidney function due to undetermined cause in India: an environmental epidemiologic analysis.印度不明原因肾功能减退的环境危险因素:一项环境流行病学分析。
Environ Epidemiol. 2021 Sep 24;5(5):e170. doi: 10.1097/EE9.0000000000000170. eCollection 2021 Oct.
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Occupational heat exposure and the risk of chronic kidney disease of nontraditional origin in the United States.职业性热暴露与美国非传统来源的慢性肾脏病风险。
Am J Physiol Regul Integr Comp Physiol. 2021 Aug 1;321(2):R141-R151. doi: 10.1152/ajpregu.00103.2021. Epub 2021 Jun 23.
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Associations between exposure to heavy metals and the risk of chronic kidney disease: a systematic review and meta-analysis.重金属暴露与慢性肾脏病风险之间的关联:系统评价和荟萃分析。
Crit Rev Toxicol. 2021 Feb;51(2):165-182. doi: 10.1080/10408444.2021.1891196. Epub 2021 May 7.
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High Incidence of Chronic Kidney Disease among Iranian Diabetic Adults: Using CKD-EPI and MDRD Equations for Estimated Glomerular Filtration Rate.伊朗成年糖尿病患者慢性肾脏病发病率高:应用 CKD-EPI 和 MDRD 方程估算肾小球滤过率。
Diabetes Metab J. 2021 Sep;45(5):684-697. doi: 10.4093/dmj.2020.0109. Epub 2021 Mar 16.
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CKD Progression and Mortality Among Men and Women: A Nationwide Study in Sweden.CKD 进展和男女患者死亡率:瑞典全国研究。
Am J Kidney Dis. 2021 Aug;78(2):190-199.e1. doi: 10.1053/j.ajkd.2020.11.026. Epub 2021 Jan 9.
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Evidence of nickel and other trace elements and their relationship to clinical findings in acute Mesoamerican Nephropathy: A case-control analysis.急性中美洲肾病中镍和其他微量元素的证据及其与临床发现的关系:病例对照分析。
PLoS One. 2020 Nov 10;15(11):e0240988. doi: 10.1371/journal.pone.0240988. eCollection 2020.
8
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9
Risk of Kidney Injury among Construction Workers Exposed to Heat Stress: A Longitudinal Study from Saudi Arabia.建筑工人暴露于热应激下的肾脏损伤风险:来自沙特阿拉伯的纵向研究。
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Both hyperthermia and dehydration during physical work in the heat contribute to the risk of acute kidney injury.在高温环境下进行体力活动时,体温过高和脱水都会增加急性肾损伤的风险。
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