1
|
Lao XQ, Bo Y, Chen D, Zhang K, Szeto CC. Environmental pollution to kidney disease: an updated review of current knowledge and future directions. Kidney Int 2024; 106:214-225. [PMID: 38797324 DOI: 10.1016/j.kint.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
Environmental pollution significantly impacts global disease burden. However, the contribution of environmental pollution to kidney disease is often overlooked in nephrology. This review examines the growing body of research demonstrating the significant impacts of environmental pollutants, with a focus on air pollution as a primary factor, and acknowledges the roles of other pollutants, such as heavy metals, in the development and progression of kidney diseases. Short-term exposure to air pollution is linked with an increased risk of kidney disease-related events, including hospital admissions, and death, predominantly occurring in vulnerable populations. In contrast, long-term exposure, even at low to moderate levels, may lead to progressive pathophysiological changes, such as chronic systemic inflammation and oxidative stress, that contribute to the development of kidney disease. In addition, air pollution may exacerbate traditional kidney disease risk factors such as hypertension and diabetes, thereby accelerating disease progression. The review also explores how climate change may interact with various pollutants, including air pollution, influencing kidney disease indirectly. The examined evidence underscores the urgent need for an interdisciplinary approach to research further into environmental kidney disease. Environmental health policies could play a crucial role in the prevention, intervention, and improvement of kidney health worldwide.
Collapse
Affiliation(s)
- Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China; School of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Yacong Bo
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Dezhong Chen
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Cheuk-Chun Szeto
- Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
2
|
Yan M, Li T. A Review of the Interactive Effects of Climate and Air Pollution on Human Health in China. Curr Environ Health Rep 2024; 11:102-108. [PMID: 38351403 DOI: 10.1007/s40572-024-00432-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 05/12/2024]
Abstract
PURPOSE OF REVIEW Through a systematic search of peer-reviewed epidemiologic studies, we reviewed the literature on the human health impacts of climate and ambient air pollution, focusing on recently published studies in China. Selected previous literature is discussed where relevant in tracing the origins. RECENT FINDINGS Climate variables and air pollution have a complex interplay in affecting human health. The bulk of the literature we reviewed focuses on the air pollutants ozone and fine particulate matter and temperatures (including hot and cold extremes). The interaction between temperature and ozone presented substantial interaction, but evidence about the interactive effects of temperature with other air pollutants is inconsistent. Most included studies used a time-series design, usually with daily mean temperature and air pollutant concentration as independent variables. Still, more needs to be studied about the co-occurrence of climate and air pollution. The co-occurrence of extreme climate and air pollution events is likely to become an increasing health risk in China and many parts of the world as climate changes. Climate change can interact with air pollution exposure to amplify risks to human health. Challenges and opportunities to assess the combined effect of climate variables and air pollution on human health are discussed in this review. Implications from epidemiological studies for implementing coordinated measures and policies for addressing climate change and air pollution will be critical areas of future work.
Collapse
Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Tiantian Li
- CDC Key Laboratory of Environment and Population Health, Chinese Center for Disease Control and Prevention, National Institute of Environmental Health, Beijing, China.
| |
Collapse
|
3
|
Chu L, Chen K, Yang Z, Crowley S, Dubrow R. A unified framework for assessing interaction effects among environmental exposures in epidemiologic studies: A case study on temperature, air pollution, and kidney-related conditions in New York state. ENVIRONMENTAL RESEARCH 2024; 248:118324. [PMID: 38301759 DOI: 10.1016/j.envres.2024.118324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/05/2023] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND There are various methods to assess interaction effects. However, current methods have limitations, and quantification of interaction effects is rarely performed. This study aimed to develop a unified quantitative framework for assessing interaction effects. METHODS We proposed a novel framework using log-linear models with a product term(s) across the exposures that generates parametric bi-variate association and interaction effect surfaces and allows flexible functional forms for exposures in the interaction term(s). In a case study, we assessed the interaction effects between temperature and air pollution (i.e., PM2.5, NO2, and O3) on risk for kidney-related conditions in New York State (2007-2016) using a case-crossover design with conditional logistic models. Our measures of exposure were the moving averages at lag 0-5 days for air pollution (linear) and daytime mean outdoor wet-bulb globe temperature (WBGT; using a natural cubic spline). RESULTS We derived closed-form expressions for the magnitude of multiplicative interaction effects (the joint relative risk divided by the product of the two conditional relative risks) and their uncertainties. In the case study, we found a Bonferroni-corrected significant multiplicative interaction effect (IE) between outdoor WBGT at the 99th percentile (median as the reference) and (1) PM2.5 (per 5 μg/m3 increase, IE = 1.052; 95 % confidence interval [CI]: 1.019, 1.087) for acute kidney failure and (2) O3 (per 5 ppb increase; IE = 1.022; 95 % CI: 1.008, 1.036) for urolithiasis (the latter being inconclusive based on the sensitivity analysis). CONCLUSIONS Our framework allows different functional forms of exposure variables in the interaction term, quantifies the magnitudes of entire-exposure-range (in addition to discrete exposure level) multiplicative interaction effects and their uncertainties in a categorical or continuous (linear or non-linear) manner, and harmonizes the two-way evaluation of effect modification. The case study underscores co-consideration of heat and air pollution when estimating health burden and designing heat/pollution alert systems.
Collapse
Affiliation(s)
- Lingzhi Chu
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
| | - Zhuoran Yang
- Department of Statistics and Data Science, Yale University, 24 Hillhouse Avenue, New Haven, CT, 06511-6814, USA
| | - Susan Crowley
- Department of Medicine (Nephrology), Yale University School of Medicine, New Haven, CT, 06520, USA; Veterans Administration Health Care System of Connecticut, West Haven, CT, 06516, USA
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
| |
Collapse
|
4
|
Zhang R, Liu M, Zhang W, Ling J, Dong J, Ruan Y. Short-term association between air pollution and daily genitourinary disorder admissions in Lanzhou, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:74. [PMID: 38367071 DOI: 10.1007/s10653-023-01821-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/27/2023] [Indexed: 02/19/2024]
Abstract
The aim of this study was to determine the relationship between short-term exposure to ambient air pollution and the number of daily hospital admissions for genitourinary disorders in Lanzhou. Hospital admission data and air pollutants, including PM2.5, PM10, SO2, NO2, O38h and CO, were obtained from the period 2013 to 2020. A generalized additive model (GAM) combined with distribution lag nonlinear model (DLNM) based on quasi-Poisson distribution was used by the controlling for trends, weather, weekdays and holidays. Short-term exposure to PM2.5, NO2 and CO increased the risk of genitourinary disorder admissions with RR of 1.0096 (95% CI 1.0002-1.0190), 1.0255 (95% CI 1.0123-1.0389) and 1.0686 (95% CI 1.0083-1.1326), respectively. PM10, O38h and SO2 have no significant effect on genitourinary disorders. PM2.5 and NO2 are more strongly correlated in female and ≥ 65 years patients. CO is more strongly correlated in male and < 65 years patients. PM2.5, NO2 and CO are risk factors for genitourinary morbidity, and public health interventions should be strengthened to protect vulnerable populations.
Collapse
Affiliation(s)
- Runping Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Miaoxin Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Wancheng Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jianglong Ling
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Ye Ruan
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| |
Collapse
|
5
|
Li Y, Wang Y, Fan M, Li W, Meng X, Zhou H, Zhang S, Dou Q. Association of short-term nitrogen dioxide exposure with hospitalization for urolithiasis in Xinxiang, China: a time series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:93697-93707. [PMID: 37515621 PMCID: PMC10468926 DOI: 10.1007/s11356-023-28539-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/28/2023] [Indexed: 07/31/2023]
Abstract
Urolithiasis accounts for the highest incidence of all urologic-associated hospitalizations. However, few studies have explored the effect of nitrogen dioxide (NO2) on hospitalizations for urolithiasis. We included 5956 patients with urolithiasis, collected daily meteorological and air pollution data between 2016 and 2021, and analyzed the associations between air pollutants and hospitalization, length of the hospital stay, and hospitalization costs attributable to urolithiasis. NO2 exposure was associated with an increased risk of hospitalization for urinary tract stones. For each 10-μg/m3 increase and 1-day lag of NO2, the maximum daily effect on the risk of hospitalization for urolithiasis was 1.020 (95% confidence interval [CI]: 1.001-1.039), and the cumulative effect peaked on lag day 4 (relative risk [RR]: 1.061; 95% CI: 1.003-1.122). Attribution scores and quantitative analysis revealed that the mean number of hospital days and mean hospital costs were 16 days and 21,164.39 RMB, respectively. Up to 5.75% of all urolithiasis hospitalizations were estimated to be attributable to NO2, and the cost of NO2-related urolithiasis hospitalizations reached approximately 3,430,000 RMB. Stratified analysis showed that NO2 had a more sensitive impact on urolithiasis hospitalizations in women and in those aged ≥65 years. Notably, men and those younger than 65 years of age (exclude people aged 65) incurred more costs for urolithiasis hospitalizations. In the population level, the association between NO2 and risk of urolithiasis hospitalization was more pronounced during the warm season. NO2 can increase hospitalizations for urolithiasis for Xinxiang City residents, and there is a cumulative lag effect. Focusing on air pollution may have practical significance in terms of the prevention and control of urolithiasis.
Collapse
Affiliation(s)
- Yangdong Li
- The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, Xinxiang, Henan Province, 453100, People's Republic of China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, 453003, People's Republic of China
| | - Maochuan Fan
- The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, Xinxiang, Henan Province, 453100, People's Republic of China
| | - Weisheng Li
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan Province, 450003, People's Republic of China
| | - Xiangzhen Meng
- The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, Xinxiang, Henan Province, 453100, People's Republic of China
| | - Hao Zhou
- The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, Xinxiang, Henan Province, 453100, People's Republic of China
| | - Shaohua Zhang
- The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, Xinxiang, Henan Province, 453100, People's Republic of China
| | - Qifeng Dou
- The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, Xinxiang, Henan Province, 453100, People's Republic of China.
| |
Collapse
|
6
|
Chu L, Chen K, Di Q, Crowley S, Dubrow R. Associations between short-term exposure to PM 2.5, NO 2 and O 3 pollution and kidney-related conditions and the role of temperature-adjustment specification: A case-crossover study in New York state. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 328:121629. [PMID: 37054868 DOI: 10.1016/j.envpol.2023.121629] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
Epidemiologic evidence on the relationship between air pollution and kidney disease remains inconclusive. We evaluated associations between short-term exposure to PM2.5, NO2 and O3 and unplanned hospital visits for seven kidney-related conditions (acute kidney failure [AKF], urolithiasis, glomerular diseases [GD], renal tubulo-interstitial diseases, chronic kidney disease, dysnatremia, and volume depletion; n = 1,209,934) in New York State (2007-2016). We applied a case-crossover design with conditional logistic regression, controlling for temperature, dew point temperature, wind speed, and solar radiation. We used a three-pollutant model at lag 0-5 days of exposure as our main model. We also assessed the influence of model adjustment using different specifications of temperature by comparing seven temperature metrics (e.g., dry-bulb temperature, heat index) and five intraday temperature measures (e.g., daily mean, daily minimum, nighttime mean), according to model performance and association magnitudes between air pollutants and kidney-related conditions. In our main models, we adjusted for daytime mean outdoor wet-bulb globe temperature, which showed good model performance across all kidney-related conditions. We observed the odds ratios (ORs) for 5 μg/m3 increase in daily mean PM2.5 to be 1.013 (95% confidence interval [CI]: 1.001, 1.025) for AKF, 1.107 (95% CI: 1.018, 1.203) for GD, and 1.027 (95% CI: 1.015, 1.038) for volume depletion; and the OR for 5 ppb increase in daily 1-hour maximum NO2 to be 1.014 (95% CI; 1.008, 1.021) for AKF. We observed no associations with daily 8-hour maximum O3 exposure. Association estimates varied by adjustment for different intraday temperature measures: estimates adjusted for measures with poorer model performance resulted in the greatest deviation from estimates adjusted for daytime mean, especially for AKF and volume depletion. Our findings indicate that short-term exposure to PM2.5 and NO2 is a risk factor for specific kidney-related conditions and underscore the need for careful adjustment of temperature in air pollution epidemiologic studies.
Collapse
Affiliation(s)
- Lingzhi Chu
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China
| | - Susan Crowley
- Department of Medicine (Nephrology), Yale University School of Medicine, New Haven, CT, 06520, USA; Veterans Administration Health Care System of Connecticut, West Haven, CT, 06516, USA
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
| |
Collapse
|
7
|
Feng X, Hou N, Chen Z, Liu J, Li X, Sun X, Liu Y. Secular trends of epidemiologic patterns of chronic kidney disease over three decades: an updated analysis of the Global Burden of Disease Study 2019. BMJ Open 2023; 13:e064540. [PMID: 36931681 PMCID: PMC10030786 DOI: 10.1136/bmjopen-2022-064540] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVES To assess the characteristics of the global death burden imposed by chronic kidney disease (CKD) and the attributable risk factors from 1990 to 2019 to help inform a framework for policy discussions, resource allocation and research priorities. DESIGN A population-based observational study. SETTING The death data and relative risk factors were obtained from the Global Burden of Disease (GBD) Study 2019 database. MAIN OUTCOME MEASURES Based on the GBD database, we estimated the death burden attributable to CKD stratified by sociodemographic index (SDI), geographic location, sex, age group, time period and risk factors from 1990 to 2019. RESULTS Over three decade study period, the global number of CKD-related deaths increased from 0.60 million (95% uncertainty interval (UI): 0.57-0.63 million) in 1990 to 1.43 million (95% UI: 1.31-1.52 million) in 2019. The age-standardised death rate (ASDR) of CKD, among all causes, increased from 15th in 1990 to 10th in 2019. Globally, the ASDR in males was higher than that in females. CKD-related deaths mainly occurred in those aged over 50 years, especially in regions with higher SDIs. The ASDR was negatively related to SDI (ρ=-0.603, p<0.0001). Among risk factors, metabolic risk factors, especially systolic blood pressure, fasting plasma glucose and body mass index, were the main contributors to CKD-related deaths. Although the high-temperature-related death burden was low, the trend increased sharply in lower SDI regions. CONCLUSIONS CKD-related deaths continue to increase, with the majority occurring in elderly adults. The CKD-related death burden is higher in males than in females. Additionally, the increasing high-temperature-related death burdens in lower SDI regions should receive social attention.
Collapse
Affiliation(s)
- Xiaojin Feng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
- Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Ningning Hou
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Zhenna Chen
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Jing Liu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xue Li
- Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
- Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Xiaodong Sun
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
- Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Yongping Liu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
- Department of Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| |
Collapse
|
8
|
Wang F, Wang W, Peng S, Wang HY, Chen R, Wang J, Yang C, Li P, Wang Y, Zhang L. Effects of ambient temperature on hospital admissions for obstructive nephropathy in Wuhan, China: A time-series analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113876. [PMID: 35841652 DOI: 10.1016/j.ecoenv.2022.113876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
Under the background of global warming, it has been confirmed that heat exposure has a huge impact on human health. The current study aimed to evaluate the effects of daily mean ambient temperature on hospital admissions for obstructive nephropathy (ON) at the population level. A total of 19,494 hospitalization cases for ON in Wuhan, China from January 1, 2015 to December 31, 2018 were extracted from a nationwide inpatient database in tertiary hospitals according to the International Classification of Diseases (ICD)- 10 codes. Daily ambient meteorological and pollution data during the same period were also collected. A quasi-Poisson Generalized Linear Model (GLM) combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between daily mean temperature and daily hospital admissions for ON. Results showed that there were significantly positive associations between the daily mean temperature and ON hospital admissions. Relative to the minimum-risk temperature (-3.4 ℃), the risk of hospital admissions for ON at moderate hot temperature (25 ℃, 75th percentile) occurred from lag day 4 and stayed to lag day 12 (cumulative relative risk [RR] was 1.846, 95 % confidence interval [CI]: 1.135-3.005, over lag 0-12 days). Moreover, the risk of extreme hot temperature (32 ℃, 99th percentile) appeared immediately and lasted for 8 days (RR = 2.019, 95 % CI: 1.308-3.118, over lag 0-8 days). Subgroup analyses indicated that the middle-aged and elderly (≥45 years) patients might be more susceptible to the negative effects of high temperature, especially at moderate hot conditions. Our findings suggest that temperature may have a significant impact on the acute progression and onset of ON. Higher temperature is associated with increased risks of hospital admissions for ON, which indicates that early interventions should be taken in geographical settings with relatively high temperatures, particularly for the middle-aged and elderly.
Collapse
Affiliation(s)
- Fulin Wang
- Peking University First Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Suyuan Peng
- National Institute of Health Data Science at Peking University, Beijing, China
| | - Huai-Yu Wang
- National Institute of Health Data Science at Peking University, Beijing, China
| | - Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou, China
| | - Yang Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Luxia Zhang
- National Institute of Health Data Science at Peking University, Beijing, China; Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
| |
Collapse
|