Hsu Ching-Wei, Chan Ming-Jen, Weng Cheng-Hao, Tsai Tsung-Yu, Yen Tzung-Hai, Huang Wen-Hung
Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
Chang Gung University, College of Medicine, Taoyuan, Taiwan, Republic of China.
Ther Clin Risk Manag. 2025 Jan 3;21:1-13. doi: 10.2147/TCRM.S496491. eCollection 2025.
The negative impacts of particulate matter with an aerodynamic diameter of 2.5 μm or less (PM) are well known. Patients undergoing maintenance hemodialysis (HD) have significantly higher blood cadmium levels (BCLs) than healthy individuals. As elemental cadmium can be found in the PM particle fraction, we conducted this study to assess the effect of environmental PM exposure and other clinical variables on BCLs in maintenance HD patients.
This cross-sectional study included 754 hD patients who had previously participated in a BCL study. Demographic, hematological, biochemical and dialysis-related data were collected for analysis. For each patient, the mean PM concentrations in the living environment during the previous 12 and 24 months were recorded and analyzed.
Of all patients, the median BCL of was 0.36 µg/L (range: 0.21, 0.79 µg/L). The mean PM concentration was 28.45 ± 3.57 μg/m during the 12 months and 29.81 ± 3.47 μg/m during the 24 months, respectively. From a multivariate linear regression analysis, log BCL was positively associated with the mean PM concentration during the previous 12 and 24 months. In addition, log BCL was positively associated with the number of days with PM concentrations above the standard level during the previous 12 and 24 months. Moreover, according to the tertiles of days with a daily mean PM concentration above the normal limit in the previous 24 months, patients with the highest exposure days exhibited a significantly higher BCL than those in the other two patient groups.
Chronic environmental exposure to PM is significantly associated with BCLs in maintenance HD patients, and exposure to PM-bound cadmium may contribute to the harmful effects on health in this population. Further studies are needed to confirm these observations and to explore the underlying mechanisms.
空气动力学直径为2.5微米或更小的颗粒物（PM）的负面影响是众所周知的。接受维持性血液透析（HD）的患者的血镉水平（BCLs）明显高于健康个体。由于在PM颗粒部分中可以发现元素镉，我们进行了这项研究，以评估环境PM暴露和其他临床变量对维持性HD患者BCLs的影响。
这项横断面研究纳入了754名先前参与过BCL研究的HD患者。收集人口统计学、血液学、生化和透析相关数据进行分析。为每位患者记录并分析前12个月和24个月生活环境中的平均PM浓度。
在所有患者中，BCL的中位数为0.36微克/升（范围：0.21，0.79微克/升）。12个月期间的平均PM浓度分别为28.45±3.57微克/立方米，24个月期间为29.81±3.47微克/立方米。多元线性回归分析显示，log BCL与前12个月和24个月的平均PM浓度呈正相关。此外，log BCL与前12个月和24个月中PM浓度高于标准水平的天数呈正相关。此外，根据前24个月每日平均PM浓度高于正常限值的天数三分位数，暴露天数最多的患者的BCL明显高于其他两组患者。
维持性HD患者长期暴露于环境PM与BCLs显著相关，暴露于与PM结合的镉可能对该人群的健康产生有害影响。需要进一步研究来证实这些观察结果并探索潜在机制。
