Tang Wei-Zhen, Xu Wei-Ze, Liu Tai-Hang, Cai Qin-Yu, Jia Ya-Ting, Deng Bo-Yuan, Xiang Zhi-Yong, Deng Yi, Guo Peng, Ding Jun
The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, P.R. China; Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, P.R. China.
Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, P.R. China.
J Nutr Health Aging. 2025 Aug 1;29(10):100641. doi: 10.1016/j.jnha.2025.100641.
The study investigates the link between indoor air pollution from non-clean fuels and kidney function decline, particularly in middle-aged and elderly individuals in China.
This prospective cohort study included 4,207 participants, with kidney function assessed through eGFR (using serum creatinine and cystatin C). Logistic regression models were used to examine the link between household solid fuel use and the risk of rapid kidney decline and CKD. Sensitivity analyses were also conducted using eGFR estimates based on creatinine or cystatin C alone.
Trend regression revealed that more frequent solid fuel use was associated with higher risks of both rapid kidney decline and CKD. Using solid fuels only for cooking was associated with a higher risk of CKD (OR 1.70; 95% CI: 1.07-2.70). Participants who switched from solid to clean fuels for cooking showed no significant changes in kidney function. Subgroup analysis revealed that women, individuals with lower education, non-smokers, non-drinkers, and those married or cohabiting had higher risks of rapid kidney decline and CKD with solid fuel use for heating. Similarly, those with lower education, non-smokers, and married/cohabiting individuals also had increased CKD risk with solid fuel use for cooking. Patients with gastrointestinal diseases had a significantly higher risk of rapid kidney function decline when using solid fuels for heating. Hypertensive patients had elevated risks of both rapid kidney decline and CKD with solid fuel use. Residents of concrete or steel multi-story buildings using solid fuels had the highest risks of rapid kidney decline and CKD. Those living in homes smaller than 120 square meters with solid fuel use also faced increased risks of kidney function decline.
The results show a strong link between household air pollution and increased risk of kidney disesases. Improving household heating and cooking conditions could help prevent kidney damage.
本研究调查了使用非清洁燃料导致的室内空气污染与肾功能下降之间的联系，特别是在中国的中老年人中。
这项前瞻性队列研究纳入了4207名参与者，通过估算肾小球滤过率（eGFR，使用血清肌酐和胱抑素C）评估肾功能。采用逻辑回归模型来研究家庭使用固体燃料与肾功能快速下降及慢性肾脏病（CKD）风险之间的联系。还使用仅基于肌酐或胱抑素C的eGFR估算值进行了敏感性分析。
趋势回归显示，更频繁地使用固体燃料与肾功能快速下降和CKD的更高风险相关。仅将固体燃料用于烹饪与CKD的较高风险相关（比值比1.70；95%置信区间：1.07 - 2.70）。从使用固体燃料改为使用清洁燃料烹饪的参与者肾功能无显著变化。亚组分析显示，女性、受教育程度较低者、不吸烟者、不饮酒者以及已婚或同居者使用固体燃料取暖时，肾功能快速下降和CKD的风险更高。同样，受教育程度较低者、不吸烟者以及已婚/同居者使用固体燃料烹饪时，CKD风险也增加。患有胃肠道疾病的患者使用固体燃料取暖时，肾功能快速下降的风险显著更高。高血压患者使用固体燃料时，肾功能快速下降和CKD的风险均升高。居住在混凝土或钢结构多层建筑中且使用固体燃料的居民，肾功能快速下降和CKD的风险最高。居住在面积小于120平方米且使用固体燃料的房屋中的居民，肾功能下降的风险也增加。
结果表明家庭空气污染与肾脏疾病风险增加之间存在紧密联系。改善家庭取暖和烹饪条件有助于预防肾脏损害。
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