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Hamroun A, Génin M, Glowacki F, Sautenet B, Leffondré K, De Courrèges A, Dauchet L, Gauthier V, Bayer F, Lassalle M, Couchoud C, Amouyel P, Occelli F. Multiple air pollutant exposure is associated with higher risk of all-cause mortality in dialysis patients: a French registry-based nationwide study. Front Public Health 2024; 12:1390999. [PMID: 39139668 PMCID: PMC11319261 DOI: 10.3389/fpubh.2024.1390999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/16/2024] [Indexed: 08/15/2024] Open
Abstract
Background Little is known about the effect of combined exposure to different air pollutants on mortality in dialysis patients. This study aimed to investigate the association of multiple exposures to air pollutants with all-cause and cause-specific death in dialysis patients. Materials and methods This registry-based nationwide cohort study included 90,373 adult kidney failure patients initiating maintenance dialysis between 2012 and 2020 identified from the French REIN registry. Estimated mean annual municipality levels of PM2.5, PM10, and NO2 between 2009 and 2020 were combined in different composite air pollution scores to estimate each participant's exposure at the residential place one to 3 years before dialysis initiation. Adjusted cause-specific Cox proportional hazard models were used to estimate hazard ratios (HRs) per interquartile range (IQR) greater air pollution score. Effect measure modification was assessed for age, sex, dialysis care model, and baseline comorbidities. Results Higher levels of the main air pollution score were associated with a greater rate of all-cause deaths (HR, 1.082 [95% confidence interval (CI), 1.057-1.104] per IQR increase), regardless of the exposure lag. This association was also confirmed in cause-specific analyses, most markedly for infectious mortality (HR, 1.686 [95% CI, 1.470-1.933]). Sensitivity analyses with alternative composite air pollution scores showed consistent findings. Subgroup analyses revealed a significantly stronger association among women and fewer comorbid patients. Discussion Long-term multiple air pollutant exposure is associated with all-cause and cause-specific mortality among patients receiving maintenance dialysis, suggesting that air pollution may be a significant contributor to the increasing trend of CKD-attributable mortality worldwide.
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Affiliation(s)
- Aghiles Hamroun
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, INSERM, Université de Lille, CHU Lille, Lille, France
| | - Michaël Génin
- ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Université de Lille, CHU Lille, Lille, France
| | | | - Bénédicte Sautenet
- Service de Néphrologie-Hypertension Artérielle, Dialyses, Transplantation Rénale, CHRU de Tours, Tours, France
- Department of Nephrology, Université de Tours, Tours, France
- INI-CRCT, Vandœuvre-lès-Nancy, France
- INSERM U1246 SPHERE, Université de Tours-Université de Nantes, Tours, France
| | - Karen Leffondré
- INSERM, Bordeaux Population Health Research Center, Université de Bordeaux, Bordeaux, France
| | - Antoine De Courrèges
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
| | - Luc Dauchet
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, INSERM, Université de Lille, CHU Lille, Lille, France
| | - Victoria Gauthier
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, INSERM, Université de Lille, CHU Lille, Lille, France
| | - Florian Bayer
- Coordination Nationale Registre REIN, Agence de la Biomédecine, Saint-Denis, France
| | - Mathilde Lassalle
- Coordination Nationale Registre REIN, Agence de la Biomédecine, Saint-Denis, France
| | - Cécile Couchoud
- Coordination Nationale Registre REIN, Agence de la Biomédecine, Saint-Denis, France
| | - Philippe Amouyel
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, INSERM, Université de Lille, CHU Lille, Lille, France
| | - Florent Occelli
- IMT Lille Douai, JUNIA, ULR LGCgE, Laboratoire de Génie Civil et Géo-Environnement, Université de Lille, Université de Artois, Lille, France
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Nagai K, Araki S, Sairenchi T, Ueda K, Yamagishi K, Shima M, Yamamoto K, Iso H, Irie F. Particulate Matter and Incident Chronic Kidney Disease in Japan: The Ibaraki Prefectural Health Study (IPHS). JMA J 2024; 7:334-341. [PMID: 39114627 PMCID: PMC11301005 DOI: 10.31662/jmaj.2024-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/29/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction 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. Methods We examined 77,770 men and women with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 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 m2 during follow-up. To assess air pollution, a PM2.5 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 PM2.5 concentrations in residential areas as a risk factor for outcomes. Results Participants were distributed across 23 municipalities in the Ibaraki Prefecture, with PM2.5 concentrations between 16.2 and 33.4 μg/m3 (mean, 22.7 μg/m3) in 1987-1995 as the exposure period. There were 942 newly developed kidney dysfunctions during follow-up. Based on 1987-1995 PM2.5 concentrations as the baseline exposure, the multivariate-adjusted hazard ratio per 10-μg/m3 increase in PM2.5 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. Conclusions Elevated PM2.5 did not represent a significant risk factor for incident CKD in a prefecture in Japan.
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Affiliation(s)
- Kei Nagai
- Department of Nephrology, Hitachi General Hospital, Hitachi, Japan
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shin Araki
- Graduate School of Engineering, Osaka University, Suita, Japan
| | - Toshimi Sairenchi
- Medical Science of Nursing, Dokkyo Medical University School of Nursing, Shimotsuga, Japan
- Department of Public Health, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Kazumasa Yamagishi
- Department of Public Health, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Masayuki Shima
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kouhei Yamamoto
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Hiroyasu Iso
- Institute of Global Health Policy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan
| | - Fujiko Irie
- Tsuchiura Public Health Center of Ibaraki Prefectural Government, Tsuchiura, Japan
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An Q, Wang Q, Liu R, Zhang J, Li S, Shen W, Zhou H, Liang Y, Li Y, Mu L, Lei L. Analysis of relationship between mixed heavy metal exposure and early renal damage based on a weighted quantile sum regression and Bayesian kernel machine regression model. J Trace Elem Med Biol 2024; 84:127438. [PMID: 38520795 DOI: 10.1016/j.jtemb.2024.127438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Occupation, environmental heavy metal exposure, and renal function impairment are closely related. The relationship between mixed metal exposure and chronic renal injury is inadequately described, and the interaction between each metal is poorly explored. OBJECTIVE This cross-sectional study assessed mixed heavy metal exposure in the general population and their relationship with early renal impairment, as well as possible interactions between metals. METHODS The study was conducted in two communities in Taiyuan City in northern China. Multiple linear regression, weighted quantile sum (WQS) and bayesian kernel machine regression (BKMR) regression were used to explore the relationship of mixed heavy metal exposure with indicators of early kidney injury (N-acetyl-β-D- glucosidase (UNAG), urinary albumin (UALB)). Meanwhile, BKMR was used to explore the possible interactions between mixed heavy metal and indicators of early kidney injury. RESULTS Based on the WQS regression results, we observed adjusted WQS coefficient β (β-WQS) of 0.711 (95% CI: 0.543, 0.879). Notably, this change was primarily driven by As (35.6%) and Cd (22.5%). In the UALB model, the adjusted β-WQS was 0.657 (95% CI: 0.567, 0.747), with Ni (30.5%), Mn (22.1%), Cd (21.2%), and As (18.6%) exhibiting higher weights in the overall effect. The BKMR results showed a negative interaction between As and other metals in the UNAG and UALB models, a positive interaction between Mn and Ni and other metals. No significant pairwise interaction was observed in the association of metals with indicators of early kidney injury. CONCLUSION Through multiple linear regression, WQS regression, and BKMR analyses, we found that exposure to mixed heavy metals such as Cd, Cr, Pb, Mn, As, Co and Ni was positively correlated with UNAG and UALB. Moreover, there are complex interactions between two or more heavy metals in more than one direction.
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Affiliation(s)
- Qi An
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China
| | - Qingyao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China
| | - Rujie Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Jiachen Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Shuangjing Li
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Weitong Shen
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Han Zhou
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Yufen Liang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Yang Li
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China.
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Fu M, Zhu Z, Xiang Y, Yang Q, Yuan Q, Li X, Yu G. Associations of Blood and Urinary Heavy Metals with Stress Urinary Incontinence Risk Among Adults in NHANES, 2003-2018. Biol Trace Elem Res 2024:10.1007/s12011-024-04264-8. [PMID: 38884860 DOI: 10.1007/s12011-024-04264-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/05/2024] [Indexed: 06/18/2024]
Abstract
People come into contact with heavy metals in various ways in their daily lives. Accumulating evidence shows that toxic metal exposure is hazardous to human health. However, limited information is available regarding the impact of metal mixtures on stress urinary incontinence (SUI). Therefore, we used data from 10,622 adults from the 2003-2018 National Health and Nutrition Examination Survey (NHANES) to investigate the independent and comprehensive association between heavy metal co-exposure and SUI. Among them, 2455 (23.1%) had been diagnosed with SUI, while the rest had no SUI. We evaluated the independent and combined associations of 3 blood metals and 10 urinary metals with SUI risk, along with subgroup analyses according to age and gender. In the single-exposure model, blood cadmium (Cd), lead (Pb), mercury (Hg), urinary Cd, Pb, and cesium (Cs) were found to be positively connected with SUI risk. Moreover, weighted quantile sum (WQS) regression, quantile-based g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) consistently demonstrated blood and urinary metal-mixed exposure were positively associated with the risk of SUI, and emphasized that blood Pb and Cd and urinary Cd and Cs were the main positive drivers, respectively. This association was more pronounced in the young and middle-aged group (20-59 years old) and the female group. Nevertheless, further research is necessary to validate these significant findings.
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Affiliation(s)
- Maoling Fu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Aviation Road, Wuhan, 430030, Hubei, China
| | - Zifan Zhu
- School of Mental Health and Psychological Science, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yechen Xiang
- Department of Urology, Hunan University of Medicine General Hospital, Hunan University of Medicine, 370 Jinxi South Road, Huaihua, 418000, Hunan, China
| | - Qiaoyue Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Aviation Road, Wuhan, 430030, Hubei, China
| | - Quan Yuan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Aviation Road, Wuhan, 430030, Hubei, China
| | - Xinyu Li
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Aviation Road, Wuhan, 430030, Hubei, China
| | - Genzhen Yu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, Hubei, China.
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Chen H, Ding X, Zhang W, Dong X. Coal mining environment causes adverse effects on workers. Front Public Health 2024; 12:1368557. [PMID: 38741904 PMCID: PMC11090038 DOI: 10.3389/fpubh.2024.1368557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
Background The objective of this study is to study the adverse effects of coal mining environment on workers to discover early effective biomarkers. Methods The molecular epidemiological study was conducted with 502 in-service workers, who were divided into miner and auxiliary. We measured the individual levels of dust exposure for participants. Clinical examinations were conducted by qualified doctors. Peripheral blood was collected to measure biochemistry, hemogram, and karyocyte apoptosis. Results All workers were healthy who have not found with any diseases that can be diagnosed medically in the physical examination and showed no difference in dust exposure level, age, height, weight, and body mass index between groups. The working years of miners were lower than that of auxiliaries (p < 0.001). Compared with auxiliaries, the concentration and percentage of lymphocytes (p = 0.040, p = 0.012), basophils (p = 0.027, p = 0.034), and red blood cells (p < 0.001) and the concentration of hemoglobin of miners were lower (p < 0.001). The percentage of neutrophils (p = 0.003), the concentration of mean corpuscular hemoglobin concentration (p = 0.002), and the proportion of karyocyte apoptosis in miners were higher (p < 0.001). Miners presented higher blood urea nitrogen (p < 0.001), ratio of blood urea nitrogen to creatinine (p < 0.001), the high density lipoprotein cholesterol (p < 0.001), lower creatinine (p < 0.05), and cholesterol (p < 0.001). Conclusion The coal mining environment impacted mining workers' immune function, renal function, and the hematopoietic system, including BUN/CRE, HGB, RBC, and LYMPH, which could be used as early biomarkers to screen the health of coal miners.
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Affiliation(s)
- Huihui Chen
- Wannan Medical College, Wuhu, Anhui, China
- Guang’anmen Hospital China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinping Ding
- Huaibei Occupational Disease Prevention and Control Institute, Huaibei, Anhui, China
| | | | - Xichen Dong
- Guang’anmen Hospital China Academy of Chinese Medical Sciences, Beijing, China
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Wathanavasin W, Banjongjit A, Phannajit J, Eiam-Ong S, Susantitaphong P. Association of fine particulate matter (PM 2.5) exposure and chronic kidney disease outcomes: a systematic review and meta-analysis. Sci Rep 2024; 14:1048. [PMID: 38200164 PMCID: PMC10781728 DOI: 10.1038/s41598-024-51554-1] [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: 10/03/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024] Open
Abstract
Several studies have reported an increased risk of chronic kidney disease (CKD) outcomes after long-term exposure (more than 1 year) to particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5). However, the conclusions remain inconsistent. Therefore, we conducted this meta-analysis to examine the association between long-term PM2.5 exposure and CKD outcomes. A literature search was conducted in PubMed, Scopus, Cochrane Central Register of Controlled trials, and Embase for relevant studies published until August 10, 2023. The main outcomes were incidence and prevalence of CKD as well as incidence of end-stage kidney disease (ESKD). The random-effect model meta-analyses were used to estimate the risk of each outcome among studies. Twenty two studies were identified, including 14 cohort studies, and 8 cross-sectional studies, with a total of 7,967,388 participants. This meta-analysis revealed that each 10 μg/m3 increment in PM2.5 was significantly associated with increased risks of both incidence and prevalence of CKD [adjusted odds ratio (OR) 1.31 (95% confidence interval (CI) 1.24 to 1.40), adjusted OR 1.31 (95% CI 1.03 to 1.67), respectively]. In addition, the relationship with ESKD incidence is suggestive of increased risk but not conclusive (adjusted OR 1.16; 95% CI 1.00 to 1.36). The incidence and prevalence of CKD outcomes had a consistent association across all subgroups and adjustment variables. Our study observed an association between long-term PM2.5 exposure and the risks of CKD. However, more dedicated studies are required to show causation that warrants urgent action on PM2.5 to mitigate the global burden of CKD.
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Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, Thailand
| | - Jeerath Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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Sarkaki A, Badavi M, Nejaddehbashi F, Hajipour S, Basir Z, Amini N. The renoprotective effects of hesperidin on kidney injury induced by exposure to severe chronic dust storm particulate matter through inhibiting the Smads/TGF-β1 signaling in rat. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:3615-3626. [PMID: 37272929 DOI: 10.1007/s00210-023-02562-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/30/2023] [Indexed: 06/06/2023]
Abstract
Exposure to dust storm particulate matter (PM) is detrimental to kidney tissue. In this study, the impacts of chronic intake of dusty PM were explored as a major objective in a specified compartment to make a real-like dust storm (DS) model, and the role of hesperidin (HSP) as an antioxidant on kidney tissue was assessed in rats. Thirty-two male Wistar rats (200-220 g) were randomly allocated into 4 groups: CA+NS: (clean air and normal saline as a vehicle of HSP). Dusty PM and NS (DS+NS). HSP+ CA: rats received 200 mg/kg of HSP by gavage for 28 days, once daily in addition to exposure to clean air. HSP+DS: HSP plus DS. In DS groups, the animals were exposed to dust storms at a concentration of 5000-8000 μg/m3 in the chamber for 1 h daily, for 4 consecutive weeks, except Thursdays and Fridays. At the end of the experiment, the animals were sacrificed for biochemical, inflammatory, oxidative stress, molecular parameters, and histological evaluation. DS significantly enhanced blood urea nitrogen and creatinine, inflammatory (tumor necrosis factor-α, and interleukin-1β), and oxidative stress indexes. Likewise, a significant increase was seen in mRNA Smads, collagen-I, and transforming growth factor-β1 (TGF-β1) expressions in the kidney. Histological findings showed contracted glomeruli and kidney structure disorder. In addition, Masson's trichrome staining demonstrated renal fibrosis. Nevertheless, HSP could significantly reverse these changes. Our data confirmed that DS results in kidney fibrosis through enhancing Smads/TGF-β1 signaling. However, HSP was able to inhibit these changes as confirmed by histological findings.
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Affiliation(s)
- Alireza Sarkaki
- Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Persian Gulf Physiology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Medicinal Plants Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Badavi
- Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Persian Gulf Physiology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fereshteh Nejaddehbashi
- Cellular and molecular research center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Somayeh Hajipour
- Persian Gulf Physiology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Basir
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Negin Amini
- Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Persian Gulf Physiology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Cellular and molecular research center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zhang Y, Xia Y, Chang Q, Ji C, Zhao Y, Zhang H. Exposure to ambient air pollution and metabolic kidney diseases: evidence from the Northeast China Biobank. Nephrol Dial Transplant 2023; 38:2222-2231. [PMID: 36866507 DOI: 10.1093/ndt/gfad042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND At present, there is no epidemiological evidence of the association between metabolic kidney diseases (MKD) and exposure to air pollution. METHODS We investigated the association between exposure to long-term air pollution and the risk of developing MKD using samples from the Northeast China Biobank. RESULTS Data from 29 191 participants were analyzed. MKD prevalence was 3.23%. Every standard deviation increment in PM2.5 increased the risk of MKD [odds ratio (OR) = 1.37, 95% confidence interval (CI) 1.19-1.58), diabetic kidney disease (DKD) (OR = 2.03, 95% CI 1.52-2.73), hypertensive kidney disease (BKD) (OR = 1.31, 95% CI 1.11-1.56), hyperlipidemic kidney disease (PKD) (OR = 1.39, 95% CI 1.19-1.63) and obese kidney disease (OKD) (OR = 1.34, 95% CI 1.00-1.81). PM10 increased the risk of MKD (OR = 1.42, 95% CI 1.20-1.67), DKD (OR = 1.38, 95% CI 1.03-1.85), BKD (OR = 1.30, 95% CI 1.07-1.58) and PKD (OR = 1.50, 95% CI 1.26-1.80). Sulfur dioxide increased the risk of MKD (OR = 1.57, 95% CI 1.34-1.85), DKD (OR = 1.81, 95% CI 1.36-2.40), BKD (OR = 1.44, 95% CI 1.19-1.74) and PKD (OR = 1.72, 95% CI 1.44-2.04). Ozone decreased the risk of PKD (OR = 0.83, 95% CI 0.70-0.99). Age, ethnicity and air pollution interacted to affect the risk of MKD, BKD and PKD. Associations between air pollution and CKD or metabolic disease were weaker than those with MKD. The association between air pollution and MKD became stronger when compared with participants with non-metabolic disease. CONCLUSIONS Air pollution may cause MKD or facilitate the progression from metabolic disease to renal failure.
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Affiliation(s)
- Yixiao Zhang
- Department of Urology Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical Universtiy, Shenyang, China
| | - Chao Ji
- Department of Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical Universtiy, Shenyang, China
| | - Hehua Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical Universtiy, Shenyang, China
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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.
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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.
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Grant CH, Salim E, Lees JS, Stevens KI. Deprivation and chronic kidney disease-a review of the evidence. Clin Kidney J 2023; 16:1081-1091. [PMID: 37398697 PMCID: PMC10310512 DOI: 10.1093/ckj/sfad028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Indexed: 06/27/2024] Open
Abstract
The relationship between socioeconomic deprivation and health is inequitable. Chronic kidney disease (CKD) is an archetypal disease of inequality, being more common amongst those living in deprivation. The prevalence of CKD is rising driven by an increase in lifestyle-related conditions. This narrative review describes deprivation and its association with adverse outcomes in adults with non-dialysis-dependent CKD including disease progression, end-stage kidney disease, cardiovascular disease and all-cause mortality. We explore the social determinants of health and individual lifestyle factors to address whether patients with CKD who are socioeconomically deprived have poorer outcomes than those of higher socioeconomic status. We describe whether observed differences in outcomes are associated with income, employment, educational attainment, health literacy, access to healthcare, housing, air pollution, cigarette smoking, alcohol use or aerobic exercise. The impact of socioeconomic deprivation in adults with non-dialysis-dependent CKD is complex, multi-faceted and frequently under-explored within the literature. There is evidence that patients with CKD who are socioeconomically deprived have faster disease progression, higher risk of cardiovascular disease and premature mortality. This appears to be the result of both socioeconomic and individual lifestyle factors. However, there is a paucity of studies and methodological limitations. Extrapolation of findings to different societies and healthcare systems is challenging, however, the disproportionate effect of deprivation in patients with CKD necessitates a call to action. Further empirical study is warranted to establish the true cost of deprivation in CKD to patients and societies.
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Affiliation(s)
- Christopher H Grant
- The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Govan, Glasgow, UK
- College of Medical, Veterinary & Life Sciences, The University of Glasgow, Glasgow, UK
| | - Ehsan Salim
- College of Medical, Veterinary & Life Sciences, The University of Glasgow, Glasgow, UK
| | - Jennifer S Lees
- The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Govan, Glasgow, UK
- College of Medical, Veterinary & Life Sciences, The University of Glasgow, Glasgow, UK
| | - Kate I Stevens
- The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Govan, Glasgow, UK
- College of Medical, Veterinary & Life Sciences, The University of Glasgow, Glasgow, UK
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11
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Su WY, Wu DW, Tu HP, Chen SC, Hung CH, Kuo CH. Association between ambient air pollutant interaction with kidney function in a large Taiwanese population study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-28042-6. [PMID: 37328721 DOI: 10.1007/s11356-023-28042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/29/2023] [Indexed: 06/18/2023]
Abstract
The associations and interactions between kidney function and other air pollutants remain poorly defined. Therefore, the aim of this study was to evaluate associations among air pollutants, including particulate matter (PM) with a diameter ≤ 2.5 μm (PM2.5), PM10 (PM with a diameter ≤ 10 μm), carbon monoxide (CO), nitrogen oxide (NO), nitrogen oxides (NOx), sulfur dioxide (SO2), and ozone (O3) with kidney function, and explore interactions among these air pollutants on kidney function. We used the Taiwan Air Quality Monitoring and Taiwan Biobank databases to derive data on community-dwelling individuals in Taiwan and daily air pollution levels, respectively. We enrolled 26,032 participants. Multivariable analysis showed that high levels of PM2.5, PM10, O3 (all p < 0.001), and SO2 (p = 0.001) and low levels of CO, NO (both p < 0.001), and NOx (p = 0.047) were significantly correlated with low estimated glomerular filtration rate (eGFR). With regard to negative effects, the interactions between PM2.5 and PM10 (p < 0.001), PM2.5 and PM10 (p < 0.001), PM2.5 and SO2, PM10 and O3 (both p = 0.025), PM10 and SO2 (p = 0.001), and O3 and SO2 (p < 0.001) on eGFR were significantly negatively. High PM10, PM2.5, O3, and SO2 were associated with a low eGFR, whereas high CO, NO, and NOx were associated with a high eGFR. Furthermore, negative interactions between PM2.5 and PM10, O3 and SO2, PM10 and O3, PM2.5 and SO2, and PM10 and SO2 on eGFR were observed. The findings of this study have important implications for public health and environmental policy. Specifically, the results of this study may be useful in individuals and organizations to take action to reduce air pollution and promote public health.
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Affiliation(s)
- Wei-Yu Su
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd, Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd, Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China.
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| | - Chih-Hsing Hung
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd, Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
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12
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Wen F, Xie Y, Li B, Li P, Qi H, Zhang F, Sun Y, Zhang L. Combined effects of ambient air pollution and PM 2.5 components on renal function and the potential mediation effects of metabolic risk factors in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:115039. [PMID: 37235899 DOI: 10.1016/j.ecoenv.2023.115039] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Growing evidence links long-term air pollution exposure with renal function. However, little research has been conducted on the combined effects of air pollutant mixture on renal function and multiple mediation effects of metabolic risk factors. This study enrolled 8996 adults without chronic kidney disease (CKD) at baseline from the CHCN-BTH cohort study. Three-year exposure to air pollutants [particulate matter ≤ 2.5 µm (PM2.5), PM10, PM1, ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO)] and PM2.5 components [black carbon (BC), ammonium (NH4+), nitrate (NO3-), sulfate (SO42-) and organic matter (OM)] were assessed using well-validated machine learning methods. Linear mixed models were applied to investigate the associations between air pollutants and estimated glomerular filtration rate (eGFR). Quantile G-computation was used to assess the combined effects of pollutant mixtures. Causal mediation analysis and Bayesian mediation analysis were employed to estimate the mediation effects of metabolic risk factors. An interquartile range increases in BC (-0.256, 95 %CI: -0.331, -0.180) and OM (-0.603, 95 %CI: -0.810, -0.397) were significantly associated with eGFR decline; while O3 (1.151, 95 %CI: 0.813, 1.489), PM10 (0.721, 95 %CI: 0.309, 1.133), NH4+ (0.990, 95 %CI: 0.638, 1.342), and NO3- (0.610, 95 %CI: 0.405, 0.815) were associated with higher eGFR. The combined effect of the PM2.5 component mixture was found to be associated with lower eGFR (-1.147, 95 % CI: -1.456, -0.839), with OM contributing 72.4 % of the negative effect. Univariate mediation analyses showed that high-density lipoprotein (HDL) mediated 7.1 %, 6.9 %, and 6.1 % effects of O3, BC, and OM, respectively. However, these mediation effects were not significant in Bayesian mediation analysis. These findings suggest the effect of the PM2.5 component mixture on eGFR decline and the strong contribution of OM. Metabolic risk factors may not mediate the effects of air pollutants. Further study is warranted to clarify the potential mechanisms involved.
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Affiliation(s)
- Fuyuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Pandi Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Han Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fengxu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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13
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Hsu S, Bi J, de Boer IH. Invited Perspective: Still Hazy? Air Pollution and Acute Kidney Injury. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:41302. [PMID: 37036791 PMCID: PMC10084927 DOI: 10.1289/ehp12860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/19/2023]
Affiliation(s)
- Simon Hsu
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jianzhao Bi
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Ian H. de Boer
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, Washington, USA
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14
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Kanagasabai T, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Xie G, Yang X, Zhao L, Guo D, Daskalopoulou SS, Wu Y, Baumgartner J. Cross-sectional study of household solid fuel use and renal function in older adults in China. ENVIRONMENTAL RESEARCH 2023; 219:115117. [PMID: 36549492 PMCID: PMC7615253 DOI: 10.1016/j.envres.2022.115117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Emerging evidence links outdoor air pollution and declined renal function but the relationship between household air pollution and renal function is not well understood. METHODS Using cross-sectional data from the multi-provincial INTERMAP-China Prospective Study, we collected blood samples and questionnaire information on stove use and socio-demographic factors. We calculated estimated glomerular filtration rate (eGFR) from serum creatinine to assess renal function. Participants with eGFR <60 mL/min per 1.73 m2 were defined as having chronic kidney disease (CKD) in this analysis. Generalized estimating equations were used to estimate the association of household fuel with renal function and prevalent CKD in models adjusting for confounders. RESULTS Among the 646 enrolled adults (40-79y; 56% female), one-third exclusively used clean fuel (gas and electric) cookstoves and 11% of northern China participants (n = 49 of 434) used only clean fuel heaters, whereas the rest used solid fuel. In multivariable models, use of solid fuel cookstoves was associated with 0.17 ml/min/1.73 m2 (95% CI: -0.30, 0.64) higher eGFR and 19% (0.86, 1.64) higher prevalence of CKD than exclusive clean fuel use. Greater intensity of solid fuel use was associated with 0.25 ml/min/1.73 m2 (-0.71, 0.21) lower eGFR per 5 stove-use years, though the confidence intervals included the null, while greater current intensity of indoor solid fuel use was associated with 1.02 (1.00, 1.04) higher prevalent CKD per 100 stove-use days per year. Larger associations between current solid fuel use and intensity of use with lower eGFR and prevalent CKD were observed among participants in southern China, those with hypertension or diabetes (eGFR only), and females (CKD only), through these groups had small sample sizes and some confidence intervals included the null. CONCLUSION We found inconsistent evidence associating household solid fuel use and renal function in this cross-sectional study of peri-urban Chinese adults.
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Affiliation(s)
| | - Ellison Carter
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA
| | - Li Yan
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, and MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Frank Kelly
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Gaoqiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Xudong Yang
- Department of Building Science, Tsinghua University, Beijing, China
| | - Liancheng Zhao
- Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China
| | - Dongshuang Guo
- Department of Cardiology, Yuxian Hospital, Yuxian, Shanxi, China
| | - Stella S Daskalopoulou
- Department of Medicine, Division of Internal Medicine and Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China.
| | - Jill Baumgartner
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada.
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15
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López LR, Dessì P, Cabrera-Codony A, Rocha-Melogno L, Kraakman B, Naddeo V, Balaguer MD, Puig S. CO 2 in indoor environments: From environmental and health risk to potential renewable carbon source. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159088. [PMID: 36181799 DOI: 10.1016/j.scitotenv.2022.159088] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/10/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
In the developed world, individuals spend most of their time indoors. Poor Indoor Air Quality (IAQ) has a wide range of effects on human health. The burden of disease associated with indoor air accounts for millions of premature deaths related to exposure to Indoor Air Pollutants (IAPs). Among them, CO2 is the most common one, and is commonly used as a metric of IAQ. Indoor CO2 concentrations can be significantly higher than outdoors due to human metabolism and activities. Even in presence of ventilation, controlling the CO2 concentration below the Indoor Air Guideline Values (IAGVs) is a challenge, and many indoor environments including schools, offices and transportation exceed the recommended value of 1000 ppmv. This is often accompanied by high concentration of other pollutants, including bio-effluents such as viruses, and the importance of mitigating the transmission of airborne diseases has been highlighted by the COVID-19 pandemic. On the other hand, the relatively high CO2 concentration of indoor environments presents a thermodynamic advantage for direct air capture (DAC) in comparison to atmospheric CO2 concentration. This review aims to describe the issues associated with poor IAQ, and to demonstrate the potential of indoor CO2 DAC to purify indoor air while generating a renewable carbon stream that can replace conventional carbon sources as a building block for chemical production, contributing to the circular economy.
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Affiliation(s)
- L R López
- LEQUiA, Institute of Environment, University of Girona, Campus Montilivi, carrer Maria Aurelia Capmany 69, Girona, Spain.
| | - P Dessì
- LEQUiA, Institute of Environment, University of Girona, Campus Montilivi, carrer Maria Aurelia Capmany 69, Girona, Spain
| | - A Cabrera-Codony
- LEQUiA, Institute of Environment, University of Girona, Campus Montilivi, carrer Maria Aurelia Capmany 69, Girona, Spain
| | - L Rocha-Melogno
- ICF, 2635 Meridian Parkway Suite 200, Durham, NC 27713, United States
| | - B Kraakman
- Jacobs Engineering, Templey Quay 1, Bristol BAS1 6DG, UK; Institute of Sustainable Processes, University of Valladolid, Dr. Mergelina s/n., 47011 Valladolid, Spain
| | - V Naddeo
- Sanitary Environmental Engineering Division, Department of Civil Engineering, University of Salerno, 84084 Fisciano, SA, Italy
| | - M D Balaguer
- LEQUiA, Institute of Environment, University of Girona, Campus Montilivi, carrer Maria Aurelia Capmany 69, Girona, Spain
| | - S Puig
- LEQUiA, Institute of Environment, University of Girona, Campus Montilivi, carrer Maria Aurelia Capmany 69, Girona, Spain
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16
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Chen SF, Chien YH, Chen PC. The association between long-term ambient fine particulate exposure and the mortality among adult patients initiating dialysis: A retrospective population-based cohort study in Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120606. [PMID: 36368554 DOI: 10.1016/j.envpol.2022.120606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Fine particulate matter (PM2.5) has been reported to be associated with increased risk of chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, studies on whether long-term exposure to PM2.5 negatively impacts the survival of patients with ESRD are very limited. To conduct this study, we linked Taiwan Air Quality-Monitoring Database (TAQMD) and the National Health Insurance Research Database (NHIRD) by zip-code. A retrospective population-based cohort of 34,088 adult patients initiating dialysis over six months was formed. Cox proportional regression models were used to estimate the risk of mortality in dialysis patients per 10-μg/m3 increase of PM2.5 and by PM2.5 levels divided into quintiles. Restricted cubic spline analysis was performed to delineate the concentration-response relationship between PM2.5 and mortality. The adjusted hazard ratio (aHR) per 10-μg/m3 increase of PM2.5 for mortality was 1.11 (95% confidence interval [CI] = 1.08-1.13). When analyzing PM2.5 exposure divided into quintiles, patients with mean PM2.5 exposure over 29.33 μg/m3, including level III (aHR 1.00, 95% CI = 0.94-1.07), level IV (aHR 1.09; 95% CI = 1.03-1.16), and level V (HR 1.11; 95% CI = 1.05-1.19), were at stepwise higher risks of mortality compared with level I. Spline analysis showed a non-linear concentration-response function between PM2.5 and mortality, with the lowest mortality aHR identified at a mean PM2.5 of 26 μg/m3, followed by a concentration interval with a gradual increase of aHR, and finally a steep rise of mortality risk when mean PM2.5 exceeded 37 μg/m3. Individuals with older age, those were male, with selected comorbidities, and with low socioeconomic status (SES) were at higher mortality risk. Male and non-diabetics participants were more sensitive to the effect of a 10-μg/m3 of PM2.5 increase on mortality than their counterparts. In conclusion, long-term exposure to PM2.5 exceeding a threshold was observed to be associated with increased risk of mortality among dialysis patients.
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Affiliation(s)
- Shih-Feng Chen
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yu-Hui Chien
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan.
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17
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Zeng C, Guo B, Wan Y, Guo Y, Chen G, Duoji Z, Qian W, Danzhen W, Meng Q, Chen L, Wu K, Wang X, Feng S, Jiang M, Xiong H, Zhao X. The role of lipid profile in the relationship between particulate matters and hyperuricemia: A prospective population study. ENVIRONMENTAL RESEARCH 2022; 214:113865. [PMID: 35835168 DOI: 10.1016/j.envres.2022.113865] [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: 03/15/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
CONTEXT Recent studies in specific population subgroups (e.g., pregnant women) have suggested PM exposure increases the risk of hyperuricemia. However, no studies have examined this in the general population. Furthermore, the underlying mechanism through which PM impacts hyperuricemia risk is poorly understood. OBJECTIVE To assess the association between long-term exposure to PM and risk of hyperuricemia and whether this association is mediated by lipid profile. METHODS We included 5939 participants in Southwest China from the China Multi-Ethnic Cohort (baseline 2018-2019, follow-up 2020-2021). Long-term PM pollutants (PM1, PM2.5, PM10) exposure for each individual was represented by the three-year average PM levels before the baseline survey. Hyperuricemia at follow-up was defined as the serum uric acid above 7.0 mg/dL in men and 6.0 mg/dL in women. Serum lipids were measured at baseline including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). The association of PM with hyperuricemia was accessed through logistic regression. The potential mediation effects of serum lipids were evaluated through causal mediation analyses. RESULTS A total of 837 participants were newly diagnosed with hyperuricemia. The odds ratios of hyperuricemia associated with an interquartile range (IQR) increase in PM1, PM2.5, and PM10 (IQR: 21.10, 25.78, 30.43 μg m-3) were 1.72 (95% CI: 1.23, 2.39), 2.68 (95% CI: 1.59, 4.49), and 1.81 (95% CI: 1.20, 2.72), respectively. The association between PM2.5, PM1, and PM10 on hyperuricemia was mediated by HDL-C (10%) and LDL-C (3%). CONCLUSION Higher particulate matter exposure was associated with higher hyperuricemia incidence. The decline in HDL-C and rise in LDL-C partially mediated this association. These findings were conducive to scientific research about the underlying mechanism of PM on hyperuricemia.
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Affiliation(s)
- Chunmei Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yang Wan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | | | - Wen Qian
- Chengdu Center for Disease Control & Prevention, China
| | | | - Qiong Meng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, China
| | - Liling Chen
- Chongqing Municipal Center for Disease Control and Prevention, China
| | - Kunpeng Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xing Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyu Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hai Xiong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Medical School of Tibet University, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Oh J, Ye S, Kang DH, Ha E. Association between exposure to fine particulate matter and kidney function: Results from the Korea National Health and Nutrition Examination Survey. ENVIRONMENTAL RESEARCH 2022; 212:113080. [PMID: 35314162 DOI: 10.1016/j.envres.2022.113080] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The incidence and prevalence of chronic kidney disease (CKD) are increasing worldwide. Recent studies have shown that air pollution is associated with poorer kidney function. We evaluated the association of long-term exposure to air pollutants with kidney function, and with risk of CKD using data from the seventh Korean National Health and Nutrition Examination Survey (KNHANES). METHODS KNHANES data from 2016 through 2018 and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation were used to calculate estimated glomerular filtration rates (eGFRs) and define the CKD patients with eGFRs <60 mL/min/1.73 m2. After applying the sampling weights based on the complex survey design, we conducted multivariate linear regression and logistic regression analyses to examine the association of air pollutant exposure with kidney function and CKD risk, after adjusting for covariates, including gender, body mass index, education level, household income, smoking status, alcohol consumption, comorbidities, and serum triglyceride. RESULTS A total of 15,983 adults aged ≥20 years were included in the analysis. Long-term exposure to PM2.5, PM10, NO2, and CO was associated with decreases in eGFR levels (PM2.5: -4.67, 95% confidence interval (CI): -6.16, -3.18; PM10: -2.19, 95% CI: -2.84, -1.54; NO2: -1.56, 95% CI: -2.16, -0.97; CO: -1.34, 95% CI: -1.96, -0.71). Long-term exposure to PM2.5 (odds ratio (OR): 1.97, 95% CI: 1.14, 3.42) and PM10 (OR: 1.45, 95% CI: 1.10, 1.91) was associated with an increased the risk of CKD. CONCLUSIONS Annual exposure to PM2.5, PM10, NO2, and CO was significantly associated with decreased eGFR. Long-term exposure to PM2.5 and PM10 was associated with an increased risk of CKD.
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Affiliation(s)
- Jongmin Oh
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Shinhee Ye
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Republic of Korea
| | - Duk-Hee Kang
- Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine Ewha Medical Research Center, Seoul, South Korea.
| | - Eunhee Ha
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, Ewha Womans University, Ewha Medical Research Institute, College of Medicine, Seoul, Republic of Korea.
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Ni J, Li Z, Lu Y, Zhang H, Wang G, Xie J, Xie J, Wang Y, Zhang Y, Wang K, Mao W, Peng B. Relationship between exposure to cadmium, lead, and mercury and the occurrence of urinary incontinence in women. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68410-68421. [PMID: 35543783 DOI: 10.1007/s11356-022-20598-z] [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: 01/18/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Cadmium, lead, and mercury are nephrotoxic metals that are commonly found as hazardous pollutants in many areas of the USA. We examined the relationship between exposure to cadmium, lead, and mercury with the occurrence of urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) in women. This study was conducted using data on women > 20 years of age, collected between 2005 and 2016, who reported experiencing urinary incontinence in the National Health and Nutrition Examination Survey (NHANES). Restricted cubic spline analysis was used to characterize a dose-response relationship between continuous exposure to different nephrotoxic metals and the occurrence of UUI and SUI. A total of 4406 women were included in this study, with 2624 (59.6%) suffering from SUI and 3177 (72.1%) suffering from UUI in the weighted population. The results of our multivariate analysis indicated that age, race, marital status, body mass index (BMI), and exposure to nephrotoxic metals were risk factors for developing UI. The odds ratio (OR; 95% confidence interval) for developing UI was positively correlated with the exposure to cadmium and lead in women. The OR of SUI occurrence increased with increasing levels of cadmium in blood, with a peak at 4 µg/L. The OR of UUI occurrence increased with increasing levels of blood and urinary lead, with peaks at 7 µg/dL and 5 µg/L, respectively. The presence of mercury was not significantly correlated with the occurrence of SUI or UUI. Exposure to high levels of cadmium and lead, which are nephrotoxic metals, is associated with the occurrence of UI in women.
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Affiliation(s)
- Jinliang Ni
- Shanghai Clinical College, Anhui Medical University, Shanghai, 200072, China
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, 200433, China
| | - Ziye Li
- Shanghai Clinical College, Anhui Medical University, Shanghai, 200072, China
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Yi Lu
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, 200433, China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
| | - Guangchun Wang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
| | - Jinbo Xie
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
| | - Jun Xie
- Shanghai Clinical College, Anhui Medical University, Shanghai, 200072, China
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
| | - Yidi Wang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
| | - Yifan Zhang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
| | - Keyi Wang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, 200433, China
| | - Weipu Mao
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, 200433, China
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, China
| | - Bo Peng
- Shanghai Clinical College, Anhui Medical University, Shanghai, 200072, China.
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301 Yanchang Road, Jing'an District, 200072, Shanghai, People's Republic of China.
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Shen YS. Multiple pathways and mediation effects of built environment on kidney disease rate via mitigation of atmospheric threats. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:155177. [PMID: 35421457 DOI: 10.1016/j.scitotenv.2022.155177] [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: 10/30/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
Air pollution and high temperatures can increase kidney disease rate, especially under climate change. A well-designed urban environment has mediating effects on atmospheric environmental threats and promoting human health, but previous studies have overlooked these effects. This study used partial least squares modeling and urban-scale data from Taiwan to identify the crucial effects (i.e., direct, indirect, and total effects) and pathways of urban form (i.e., urban development intensity, land-use mix, and urban sprawl), urban greening (i.e., green coverage), urban industrial status (e.g., industrial level), atmospheric environment (i.e., high temperature and air pollution), and socioeconomic status (i.e., elderly ratio, medical resources, and economic status) on kidney disease rate. Maximizing land-use mix and green coverage and minimizing urban development intensity, urban sprawl, and industrial levels could help reduce kidney disease rate. Air pollution and high temperature had a mediation effect of built environment on kidney disease rate; with the mediation effect of air pollution was greater than that of high temperature. Furthermore, air pollution, high temperature, and elderly ratio increased kidney disease rate, whereas medical resources decreased kidney disease rate. This study is the first to consider the impact (i.e., direct, indirect, and total effects) and pathways of built environment characteristics on kidney disease rate. The findings revealed that an appropriate urban policy might be a practical strategy and lower kidney disease rate for a healthy city development. Moreover, this study provides a new approach for clarifying complex relationships and identifying crucial factors.
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Affiliation(s)
- Yu-Sheng Shen
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, China; Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, China; University of Chinese Academy of Sciences, Beijing, China.
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21
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Wu CY, Hsu CT, Chung MC, Chen CH, Wu MJ. Air Pollution Alleviation During COVID-19 Pandemic is Associated with Renal Function Decline in Stage 5 CKD Patients. J Multidiscip Healthc 2022; 15:1901-1908. [PMID: 36072276 PMCID: PMC9442911 DOI: 10.2147/jmdh.s371815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Methods Results Conclusion
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Affiliation(s)
- Chun-Yi Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Chia-Tien Hsu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Department of Life Science, Tunghai University, Taichung, Taiwan
| | - Ming-Ju Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medical Sciences, School of Medicine, China Medical University, Taichung, Taiwan
- RongHsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Correspondence: Ming-Ju Wu, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun Dist, Taichung City, 407219, Taiwan, Email
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22
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Ma Y, Qiu S, Zhou R. Osteoporosis in Patients With Respiratory Diseases. Front Physiol 2022; 13:939253. [PMID: 35903070 PMCID: PMC9315364 DOI: 10.3389/fphys.2022.939253] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Climate change, environmental pollution, and virus epidemics have sharply increased the number of patients suffering from respiratory diseases in recent years. Prolonged periods of illness and drug use increase the occurrence of complications in these patients. Osteoporosis is the common bone metabolism disease with respiratory disturbance, which affects prognosis and increases mortality of patients. The problem of osteoporosis in patients with respiratory diseases needs more attention. In this review, we concluded the characteristics of osteoporosis in some respiratory diseases including COPD, asthma, COVID-19, tuberculosis, and lung cancer. We revealed that hypoxia was the common pathogenesis of osteoporosis secondary to respiratory diseases, with malnutrition and corticosteroid abuse driving the progression of osteoporosis. Hypoxia-induced ROS accumulation and activated HIF-1α lead to attenuated osteogenesis and enhanced osteoclastogenesis in patients with respiratory diseases. Tuberculosis and cancer also invaded bone tissue and reduced bone strength by direct infiltration. For the treatment of osteoporosis in respiratory patients, oral-optimized bisphosphonates were the best treatment modality. Vitamin D was a necessary supplement, both for calcium absorption in osteogenesis and for improvement of respiratory lesions. Reasonable adjustment of the dose and course of corticosteroids according to the etiology and condition of patients is beneficial to prevent the occurrence and development of osteoporosis. Additionally, HIF-1α was a potential target for the treatment of osteoporosis in respiratory patients, which could be activated under hypoxia condition and involved in the process of bone remodeling.
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Affiliation(s)
- Yue Ma
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shui Qiu
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
| | - Renyi Zhou
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Renyi Zhou,
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Ghazi L, Drawz PE, Berman JD. The association between fine particulate matter (PM 2.5) and chronic kidney disease using electronic health record data in urban Minnesota. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:583-589. [PMID: 34127789 PMCID: PMC8202050 DOI: 10.1038/s41370-021-00351-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Recent evidence has shown that fine particulate matter (PM2.5) may be an important environmental risk factor for chronic kidney disease (CKD), but few studies have examined this association for individual patients using fine spatial data. OBJECTIVE To investigate the association between PM2.5 and CKD (estimated glomerular filtration rate [eGFR]<45 ml/min/1.73 m2) in the Twin-Cities area in Minnesota using a large electronic health care database (2012-2019). METHODS We estimated the previous 1-year average PM2.5 from the first eGFR (measured with the CKD Epidemiology Collaboration equation using the first available creatinine measure during the baseline period [2012-2014]) using Environmental Protection Agency downscaler modeling data at the census tract level. We evaluated the spatial relative risk and clustering of CKD prevalence using a K-function test statistic. We assessed the prevalence ratio of the PM2.5 association with CKD incidence using a mixed effect Cox model, respectively. RESULTS Patients (n = 20,289) in the fourth (PM2.5 > 10.4), third (10.3 < PM2.5 < 10.8) and second quartile (9.9 < PM2.5 < 10.3) vs. the first quartile (<9.9 μg/m3) had a 2.52[2.21, 2.87], 2.18[1.95, 2.45], and 1.72[1.52, 1.97] hazard rate of developing CKD in the fully adjusted models, respectively. We identified spatial heterogeneities and evidence of CKD clustering across our study region, but this spatial variation was accounted for by air pollution and individual covariates. SIGNIFICANCE Exposure to higher PM2.5 is associated with a greater risk for incident CKD. Improvements in air quality, specifically at hotspots, may reduce CKD.
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Affiliation(s)
- Lama Ghazi
- Clinical and Translational Research Accelerator, Department of Medicine, Section of Nephrology, Yale University, New Haven, CT, USA.
| | - Paul E Drawz
- Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, MN, USA
| | - Jesse D Berman
- Division of Environmental Health Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Hu X, Han W, Wang Y, Aunan K, Pan X, Huang J, Li G. Does air pollution modify temperature-related mortality? A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 210:112898. [PMID: 35181304 DOI: 10.1016/j.envres.2022.112898] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION There is an increasing interest in understanding whether air pollutants modify the quantitative relationships between temperature and health outcomes. The results of available studies were, however, inconsistent. This study aims to sum up the current evidence and provide a comprehensive understanding of this topic. METHODS We conducted an electronic search in PubMed (MEDLINE), EMBASE, Web of Science Core Collection, and ProQuest Dissertations and Theses. The modified Navigation Guide was applied to evaluate the quality and strength of evidence. We calculated pooled temperature-related mortality at low and high pollutant levels respectively, using the random-effects model. RESULTS We identified 22 eligible studies, eleven of which were included in the meta-analysis. Significant effect modification was observed on heat effects for all-cause and non-accidental mortality by particulate matter with an aerodynamic diameter of <10 μm (PM10) and ozone (O3) (p < 0.05). The excess risks (ERs) for all-cause and non-accidental mortality were 5.4% (4.4%, 6.4%) and 6.3% (4.8%, 7.8%) at the low PM10 level, 8.8% (7.5%, 10.1%) and 11.4% (8.7%, 14.2%) at the high PM10 level, respectively. As for O3, the ERs for all-cause and non-accidental mortality were 5.1% (3.9%, 6.3%) and 3.6% (0.1%, 7.2%) at the low O3 level, 7.6% (6.3%, 9.0%) and 12.5% (4.7%, 20.9%) at the high O3 level, respectively. Surprisingly, the heat effects on cardiovascular mortality were found to be lower at high carbon monoxide (CO) levels [ERs = 5.4% (3.9%, 6.9%)] than that at low levels [ERs = 9.4% (7.0%, 11.9%)]. The heterogeneity varied, but the results of sensitivity analyses were generally robust. Significant effect modification by air pollutants was not observed for heatwave or cold effects. CONCLUSIONS PM10 and O3 modify the heat-related all-cause and non-accidental mortality, indicating that policymakers should consider air pollutants when establishing heat-health warning systems. Future studies with comparable designs and settings are needed.
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Affiliation(s)
- Xin Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Wenxing Han
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Kristin Aunan
- CICERO Center for International Climate Research, N-0318, Oslo, Norway
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Wu J, Ye Q, Fang L, Deng L, Liao T, Liu B, Lv X, Zhang J, Tao J, Ye D. Short-term association of NO 2 with hospital visits for chronic kidney disease and effect modification by temperature in Hefei, China: A time series study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 237:113505. [PMID: 35462193 DOI: 10.1016/j.ecoenv.2022.113505] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND A large body of evidence has linked air pollution and temperature with chronic kidney disease (CKD) prevalence and hospitalizations. However, most studies have focused on the influence of heat stress on CKD prevalence, and the potential effect modification of temperature on the association between air pollution and CKD has not been well-investigated. In this study, we examined the associations of the whole temperature spectrum and air pollution with CKD-related hospital visits and explored whether temperature modifies the short-term association of air pollution with CKD-related hospital visits. METHODS AND FINDINGS We collected 40 276 CKD-related hospital visits from the first Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital in Hefei, China, during 2015-2019. A two-stage time-series design was conducted to investigate the associations of air pollution and daily mean temperature with CKD-related hospital visits. First, we estimated the associations between air pollution and CKD-related hospital visits as well as temperature and CKD-related hospital visits. Second, we analyzed the associations of air pollution with CKD hospital visits at different temperatures. We found that NO2 exposure and low temperature were associated with an increased risk of CKD-related hospital visits. Low temperature enhanced the association between NO2 exposure and CKD-related hospital visits, with an increase of 4.30% (95% CI: 2.47-5.92%) per 10 μg/m3 increment in NO2 at low temperature. Effect modification of the association between NO2 and the risk of CKD-related hospital visits was stronger at low temperature across the whole population. CONCLUSIONS Our findings indicate that low temperature-related chronic kidney damage should be of immediate public health concern. Impact of NO2 exposure on the risk of CKD-related hospital visits may increase under the low temperature, which suggests the need for NO2 exposure mitigation strategies in the context of climate change and an enhanced understanding of the mechanisms underlying the temperature variance of air pollution effect to help reduce the magnitude of the CKD burden on the healthcare systems.
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Affiliation(s)
- Jun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - QianLing Ye
- Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - LanLan Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - LiJun Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Tao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Bo Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - XiaoJie Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - JinHui Tao
- Department of Rheumatology & Immunology, Anhui Provincial Hospital, Hefei, Anhui, China.
| | - DongQing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
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26
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Association between gaseous air pollutants and idiopathic nephrotic syndrome in children: a 12-year population-based cohort study. Ital J Pediatr 2022; 48:70. [PMID: 35549987 PMCID: PMC9097133 DOI: 10.1186/s13052-022-01269-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background To date, there is insufficient knowledge about the association of air pollution and childhood nephrotic syndrome in the real world. This study aimed to evaluate the effects of the three common gaseous air pollutants, including sulfur dioxide, total hydrocarbon, and methane, on the risk of idiopathic nephrotic syndrome (INS) in children. Methods We collected data from the Taiwan National Health Insurance Research Database and Taiwan Air Quality-Monitoring Database. Children younger than 18 years old, identified from January 1, 2000, were followed up until the first diagnosis of INS was established or until December 31, 2012. We measured the incidence rates and hazard ratios for INS stratified based on the quartiles (Q1–Q4) of air pollutant concentration. Multivariate Cox proportional hazards models were also applied by adjusting age, sex, monthly income, and urbanization. Results Compared with participants exposed to Q1 concentrations, the adjusted hazard ratios (aHRs) for INS increased progressively along the four quartiles of sulfur dioxide, total hydrocarbon, and methane, from 1 (Q1) to 1.78 (Q4), 1 (Q1) to 3.49 (Q4), 1 (Q1) to 7.83 (Q4), respectively. Conclusions Our study revealed that children with exposure to higher concentrations of sulfur dioxide, total hydrocarbon, and methane was associated with an increased risk of INS. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01269-8.
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Lin HC, Hung PH, Hsieh YY, Lai TJ, Hsu HT, Chung MC, Chung CJ. Long-term exposure to air pollutants and increased risk of chronic kidney disease in a community-based population using a fuzzy logic inference model. Clin Kidney J 2022; 15:1872-1880. [PMID: 36158158 PMCID: PMC9494518 DOI: 10.1093/ckj/sfac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Indexed: 11/26/2022] Open
Abstract
Background Fuzzy inference systems (FISs) based on fuzzy theory in mathematics were previously applied to infer supplementary points for the limited number of monitoring sites and improve the uncertainty of spatial data. Therefore we adopted the FIS method to simulate spatiotemporal levels of air pollutants [particulate matter <2.5 μm (PM2.5), sulfur dioxide (SO2) and (NO2)] and investigated the association of levels of air pollutants with the community-based prevalence of chronic kidney disease (CKD). Methods A Complex Health Screening program was launched during 2012–2013 and a total of 8284 community residents in Chiayi County, which is located in southwestern Taiwan, received a series of standard physical examinations, including measurement of estimated glomerular filtration rate (eGFR). CKD cases were defined as eGFR <60 mL/min/1.73 m2 and were matched for age and gender in a 1:4 ratio of cases:controls. Data on air pollutants were collected from air quality monitoring stations during 2006–2016. The longitude, latitude and recruitment month of the individual case were entered into the trained FIS. The defuzzification process was performed based on the proper membership functions and fuzzy logic rules to infer the concentrations of air pollutants. In addition, we used conditional logistic regression and the distributed lag nonlinear model to calculate the prevalence ratios of CKD and the 95% confidence interval. Confounders including Framingham Risk Score (FRS), diabetes, gout, arthritis, heart disease, metabolic syndrome and vegetables consumption were adjusted in the models. Results Participants with a high FRS (>10%), diabetes, heart disease, gout, arthritis or metabolic syndrome had significantly increased CKD prevalence. After adjustment for confounders, PM2.5 levels were significantly increased in CKD cases in both single- and two-pollutant models (prevalence ratio 1.31–1.34). There was a positive association with CKD in the two-pollutant models for NO2. However, similar results were not observed for SO2. Conclusions FIS may be helpful to reduce uncertainty with better interpolation for limited monitoring stations. Meanwhile, long-term exposure to ambient PM2.5 appears to be associated with an increased prevalence of CKD, based on a FIS model.
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Affiliation(s)
- Hsueh-Chun Lin
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Peir-Haur Hung
- Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Yun-Yu Hsieh
- Department of Health Risk Management, China Medical University, Taichung, Taiwan
| | - Ting-Ju Lai
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Hui-Tsung Hsu
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chi-Jung Chung
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Xu Y, Andersson EM, Krage Carlsen H, Molnár P, Gustafsson S, Johannesson S, Oudin A, Engström G, Christensson A, Stockfelt L. Associations between long-term exposure to low-level air pollution and risk of chronic kidney disease-findings from the Malmö Diet and Cancer cohort. ENVIRONMENT INTERNATIONAL 2022; 160:107085. [PMID: 35042049 DOI: 10.1016/j.envint.2022.107085] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Associations between air pollution and chronic kidney disease (CKD) have been reported, but studies at low exposure levels and relevant exposure time windows are still warranted. This study investigated clinical CKD at low air pollution levels in the Swedish Malmö Diet and Cancer Cohort in different exposure time windows. METHODS This study included 30,396 individuals, aged 45-74 at enrollment 1991-1996. Individual annual average residential outdoor PM2.5, PM10, nitrogen oxides (NOx), and black carbon (BC) were assigned using dispersion models from enrollment to 2016. Diagnoses of incident CKD were retrieved from national registries. Cox proportional hazards models were used to obtain hazard ratios (HRs) for CKD in relation to three time-dependent exposure time windows: exposure at concurrent year (lag 0), mean exposure in the 1-5 or 6-10 preceding years (lag 1-5 and lag 6-10), and baseline exposure. RESULTS During the study period, the average annual residential exposures were 16 μg/m3 for PM10, 11 μg/m3 for PM2.5, 26 μg/m3 for NOx, and 0.97 μg/m3 for BC. For lag 1-5 and lag 6-10 exposure, significantly elevated HRs for incident CKD were found for total PM10:1.13 (95% CI: 1.01-1.26) and 1.22 (1.06-1.41); NOx: 1.19 (1.07-1.33) and 1.13 (1.02-1.25) and BC: 1.12 (1.03-1.22) and 1.11 (1.02-1.21) per interquartile range increase in exposure. For total PM2.5 the positive associations of 1.12 (0.97-1.31) and 1.16 (0.98-1.36) were not significant. For baseline or lag 0 exposure there were significant associations only for NOx and BC, not for PM. CONCLUSION Residential exposure to outdoor air pollution was associated with increased risk of incident CKD at relatively low exposure levels. Average long-term exposure was more clearly associated with CKD than current exposure or exposure at recruitment. Our findings imply that the health effects of low-level air pollution on CKD are considerable.
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Affiliation(s)
- Yiyi Xu
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Eva M Andersson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanne Krage Carlsen
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Molnár
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Sandra Johannesson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, Sweden; Section of Sustainable Health, Umeå University, 901 87 Umeå, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Anders Christensson
- Department of Nephrology, Skåne University Hospital, Malmö, Lund University, Sweden
| | - Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Abstract
The year 2021 was the last full year of Alberto Ortiz’s editorship at Clinical Kidney Journal (CKJ). On May 2022, Maria José Soler will start her term as the Editor-in-Chief. Over these years, CKJ obtained its first journal impact factor and has consolidated its position among the top journals in the field, consistently ranking among the top 25% (first quartile) journals in Urology and Nephrology. The 2020 journal impact factor rose to 4.45, becoming the top open access journal in Nephrology and the ninth ranked Nephrology journal overall. We now review the recent history of the journal and the most highly cited topics which include the epidemiology of kidney disease, chronic kidney disease topics, such as the assessment and treatment of chronic kidney disease, onconephrology, cardionephrology, glomerular disease, transplantation and coronavirus disease 2019 (COVID-19).
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Copur S, Ucku D, Kanbay M. OUP accepted manuscript. Clin Kidney J 2022; 15:1800-1802. [PMID: 36158144 PMCID: PMC9494525 DOI: 10.1093/ckj/sfac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Indexed: 12/03/2022] Open
Abstract
Air pollution is an emerging etiology of chronic kidney disease (CKD). Evidence regarding this causative relationship has been shown by several studies. Recently, Lin et al. conducted the first community-based study investigating the association between CKD prevalence and air pollutant levels utilizing a Fuzzy Logic Interference model. Despite the study's limitations, the results correlate with the previous meta-analysis and observational studies. Higher fine particular matter (PM2.5) levels are associated with the increased global burden of CKD and may also influence the unequal distribution of burden in low-to-middle income countries. Despite growing evidence of the association of air pollution with CKD risk, the underlying pathophysiology has yet to be fully understood. Future studies investigating the pathophysiology and efficiency of the potential therapeutic and preventive measures against air pollution-related kidney injury are required to reduce the CKD burden.
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Affiliation(s)
- Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Duygu Ucku
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
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Jlalia I, Chabbah T, Chatti S, Schiets F, Casabianca H, Marestin C, Mercier R, Weidner SM, Kricheldorf HR, Errachid A, Vulliet E, Hammami M, Jaffrezic‐Renault N. Alternating bio‐based pyridinic copolymers modified with hydrophilic and hydrophobic spacers as sorbents of aromatic pollutants. POLYM ADVAN TECHNOL 2021. [DOI: 10.1002/pat.5578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ibtissem Jlalia
- National Institute of Research and Physicochemical Analysis (INRAP) Biotechnopole of Sidi Thabet Ariana Tunisia
| | - Taha Chabbah
- National Institute of Research and Physicochemical Analysis (INRAP) Biotechnopole of Sidi Thabet Ariana Tunisia
- Faculty of Sciences University of Tunis El Manar Tunis Tunisia
| | - Saber Chatti
- National Institute of Research and Physicochemical Analysis (INRAP) Biotechnopole of Sidi Thabet Ariana Tunisia
| | - Frédéric Schiets
- Institute of Analytical Sciences University of Lyon Villeurbanne France
| | - Hervé Casabianca
- Institute of Analytical Sciences University of Lyon Villeurbanne France
| | | | - Regis Mercier
- Institute of Polymer Materials University of Lyon Villeurbanne France
| | | | | | | | | | - Mohamed Hammami
- National Institute of Research and Physicochemical Analysis (INRAP) Biotechnopole of Sidi Thabet Ariana Tunisia
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Chu L, Du H, Li T, Lu F, Guo M, Dubrow R, Chen K. Short-term associations between particulate matter air pollution and hospital admissions through the emergency room for urinary system disease in Beijing, China: A time-series study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 289:117858. [PMID: 34388554 DOI: 10.1016/j.envpol.2021.117858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/13/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
Evidence on the relationship between particulate matter air pollution and urinary system disease (UD) is scarce. This study aims to evaluate the associations between short-term exposures to PM2.5 and PM10 and risk of daily UD inpatient hospital admissions through the emergency room (ER-admissions) in Beijing. We obtained 41,203 weekday UD ER-admissions for secondary and tertiary hospitals in all 16 districts in Beijing during 2013-2018 from the Beijing Municipal Health Commission Information Center and obtained district-level air pollution concentrations based on 35 fixed monitoring stations in Beijing. We conducted a two-stage time-series analysis, with district-specific generalized linear models for each of Beijing's 16 districts, followed by random effects meta-analysis to obtain pooled risk estimates. We evaluated lagged and cumulative associations up to 30 days. In single-pollutant models, for both PM2.5 and PM10, cumulative exposure averaged over the day of admission and the previous 10 days (lag 0-10 days) showed the strongest association, with per interquartile range increases of PM2.5 or PM10 concentrations associated with a 7.5 % (95 % confidence interval [CI]: 3.0 %-12.2 %) or 6.0 % (95 % CI: 1.1 %-11.2 %) increased risk of daily UD hospital admissions, respectively. The risk estimates were robust to adjustment for co-pollutants and to a variety of sensitivity analyses. However, due to the strong correlation between PM2.5 and PM10 concentrations, we were unable to disentangle the respective relationships between these two exposures and UD risk. In this study, we found that short-term exposures to PM2.5 and PM10 are risk factors for UD morbidity and that cumulative exposure to PM pollution over a period of one to two weeks (i.e., 11 days) could be more important for UD risk than transient exposure during each of the respective single days.
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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
| | - Hang Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Feng Lu
- Beijing Municipal Health Commission Information Center, Beijing, 100034, China
| | - Moning Guo
- Beijing Municipal Health Commission Information Center, Beijing, 100034, China
| | - 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
| | - 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
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Phytoremediation: The Sustainable Strategy for Improving Indoor and Outdoor Air Quality. ENVIRONMENTS 2021. [DOI: 10.3390/environments8110118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Most of the world’s population is exposed to highly polluted air conditions exceeding the WHO limits, causing various human diseases that lead towards increased morbidity as well as mortality. Expenditures on air purification and costs spent on the related health issues are rapidly increasing. To overcome this burden, plants are potential candidates to remove pollutants through diverse biological mechanisms involving accumulation, immobilization, volatilization, and degradation. This eco-friendly, cost-effective, and non-invasive method is considered as a complementary or alternative tool compared to engineering-based remediation techniques. Various plant species remove indoor and outdoor air pollutants, depending on their morphology, growth condition, and microbial communities. Hence, appropriate plant selection with optimized growth conditions can enhance the remediation capacity significantly. Furthermore, suitable supplementary treatments, or finding the best combination junction with other methods, can optimize the phytoremediation process.
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Liu R, He Q, Wu Y, Wang J, Fu J. 24 h absorption and excretion profiles of cadmium from contaminated cooked brown rice and white rice in female rats. J Cereal Sci 2021. [DOI: 10.1016/j.jcs.2021.103300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Hsu CN, Tain YL. Adverse Impact of Environmental Chemicals on Developmental Origins of Kidney Disease and Hypertension. Front Endocrinol (Lausanne) 2021; 12:745716. [PMID: 34721300 PMCID: PMC8551449 DOI: 10.3389/fendo.2021.745716] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/27/2021] [Indexed: 01/09/2023] Open
Abstract
Chronic kidney disease (CKD) and hypertension are becoming a global health challenge, despite developments in pharmacotherapy. Both diseases can begin in early life by so-called "developmental origins of health and disease" (DOHaD). Environmental chemical exposure during pregnancy can affect kidney development, resulting in renal programming. Here, we focus on environmental chemicals that pregnant mothers are likely to be exposed, including dioxins, bisphenol A (BPA), phthalates, per- and polyfluoroalkyl substances (PFAS), polycyclic aromatic hydrocarbons (PAH), heavy metals, and air pollution. We summarize current human evidence and animal models that supports the link between prenatal exposure to environmental chemicals and developmental origins of kidney disease and hypertension, with an emphasis on common mechanisms. These include oxidative stress, renin-angiotensin system, reduced nephron numbers, and aryl hydrocarbon receptor signaling pathway. Urgent action is required to identify toxic chemicals in the environment, avoid harmful chemicals exposure during pregnancy and lactation, and continue to discover other potentially harmful chemicals. Innovation is also needed to identify kidney disease and hypertension in the earliest stage, as well as translating effective reprogramming interventions from animal studies into clinical practice. Toward DOHaD approach, prohibiting toxic chemical exposure and better understanding of underlying mechanisms, we have the potential to reduce global burden of kidney disease and hypertension.
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Affiliation(s)
- Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - You-Lin Tain
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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36
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Shin J, Kweon HJ, Kwon KJ, Han SH. Incidence of osteoporosis and ambient air pollution in South Korea: a population-based retrospective cohort study. BMC Public Health 2021; 21:1794. [PMID: 34610796 PMCID: PMC8493748 DOI: 10.1186/s12889-021-11866-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/27/2021] [Indexed: 02/07/2023] Open
Abstract
Background This study investigated the associations between exposure to ambient air pollutants and the incidence of osteoporosis using the Korean National Insurance Service–National Sample Cohort. Methods This nationwide, population-based, retrospective cohort study included 237,149 adults aged ≥40 years that did not have a diagnosis of osteoporosis at baseline between January 1, 2003, and December 31, 2015. Osteoporosis was defined as claim codes and prescriptions of bisphosphonates or selective estrogen receptor modulators at least twice annually. After matching values for PM10, NO2, CO, and SO2 during the 2002–2015 time period and PM2.5 in 2015 with residential areas, the incidence of osteoporosis was analyzed using a Cox proportional hazards regression model according to the quartile of average yearly concentrations of pollutants. Results Overall 22.2% of the study subjects, 52,601 (male: 5.6%, female: 37.6%) adults in total, were newly diagnosed with osteoporosis and treated. Exposure to PM10 was positively associated with incidence of osteoporosis (Q4: 1798 per 100,000 person-years vs. Q1: 1655 per 100,000 person-years). The adjusted hazard ratio (HR) with 95% confidence interval (CI) of Q4 in PM10 was 1.034 (1.009–1.062). The effect of PM10 on osteoporosis incidence was distinct in females (adjusted sub-HR: 1.065, 95% CI: 1.003–1.129), subjects aged < 65 years (adjusted sub-HR: 1.040, 95% CI: 1.010–1.072), and for residents in areas with low urbanization (adjusted sub-HR: 1.052, 95% CI: 1.019–1.087). However, there was no increase in osteoporosis based on exposure to NO2, CO, SO2, or PM2.5. Conclusions Long-term exposure to PM10 was associated with newly diagnosed osteoporosis in Korean adults aged ≥40 years. This finding can aid in policy-making that is directed to control air pollution as a risk factor for bone health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11866-7.
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Affiliation(s)
- Jinyoung Shin
- Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyuk Jung Kweon
- Department of Family Medicine, Konkuk University Medical Center, Chungju Hospital, Konkuk University School of Medicine, Chungju, South Korea
| | - Kyoung Ja Kwon
- Department of Neuroscience, Konkuk University School of Medicine, Seoul, South Korea
| | - Seol-Heui Han
- Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea.
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Feng Y, Jones MR, Ahn JB, Garonzik-Wang JM, Segev DL, McAdams-DeMarco M. Ambient air pollution and posttransplant outcomes among kidney transplant recipients. Am J Transplant 2021; 21:3333-3345. [PMID: 33870639 PMCID: PMC8500923 DOI: 10.1111/ajt.16605] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/16/2021] [Accepted: 04/03/2021] [Indexed: 01/25/2023]
Abstract
Fine particulate matter (PM2.5 ), a common form of air pollution which can induce systemic inflammatory response, is a risk factor for adverse health outcomes. Kidney transplant (KT) recipients are likely vulnerable to PM2.5 due to comorbidity and chronic immunosuppression. We sought to quantify the association between PM2.5 and post-KT outcomes. For adult KT recipients (1/1/2010-12/31/2016) in the Scientific Registry of Transplant Recipients, we estimated annual zip-code level PM2.5 concentrations at the time of KT using NASA's SEDAC Global PM2.5 Grids. We determined the associations between PM2.5 and delayed graft function (DGF) and 1-year acute rejection using logistic regression and death-censored graft failure (DCGF) and mortality using Cox proportional hazard models. All models were adjusted for sociodemographics, recipient, transplant, and ZIP code level confounders. Among 87 233 KT recipients, PM2.5 was associated with increased odds of DGF (OR = 1.59; 95% CI: 1.48-1.71) and 1-year acute rejection (OR = 1.31; 95% CI: 1.17-1.46) and increased risk of all-cause mortality (HR = 1.15; 95% CI: 1.07-1.23) but not DCGF (HR = 1.05; 95% CI: 0.97-1.51). In conclusion, PM2.5 was associated with higher odds of DGF and 1-year acute rejection and elevated risk of mortality among KT recipients. Our study highlights the importance of considering environmental exposure as risk factors for post-KT outcomes.
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Affiliation(s)
- Yijing Feng
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Miranda R. Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - JiYoon B. Ahn
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mara McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Jung J, Park JY, Kim YC, Lee H, Kim E, Kim YS, Lee JP, Kim H. Effects of air pollution on mortality of patients with chronic kidney disease: A large observational cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 786:147471. [PMID: 33971609 DOI: 10.1016/j.scitotenv.2021.147471] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/08/2021] [Accepted: 04/28/2021] [Indexed: 05/24/2023]
Abstract
Due to industrialization, the burden of diseases associated with air pollution is increasing. Although the risk associated with air pollution in the general population has been actively investigated, few studies have been conducted on the effects of exposure to air pollution in patients with chronic kidney disease (CKD) in East Asia. A total of 29,602 patients with CKD in Seoul participated in a retrospective cohort at three medical centers. We assessed the association of individualized exposure to five types of air pollutants (PM2.5, PM10, NO2, SO2, and CO) using inverse distance weighting (IDW) on mortality in CKD patients in the Cox proportional hazard model that was adjusted for sex, age, eGFR, hemoglobin, hypertension, diabetes, and area-level characteristics. During the 6.14 ± 3.96 years, 3863 deaths (13%) were observed. We confirmed the significant effects of PM2.5 (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.07-0.29) and CO (HR 1.17, 95% CI 1.00-1.38) on mortality in CKD patients. Different associations were found when stratified by age, body mass index, smoking, and drinking status. Long-term exposure to air pollutants had negative effects on mortality in patients with CKD. These effects were prominent in patients aged over 65 years, patients with a lean body, and those who did not drink alcohol.
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Affiliation(s)
- Jiyun Jung
- Data Management and Statistics Institute, Dongguk University Ilsan Hospital, South Korea
| | - Jae Yoon Park
- Department of Internal Medicine, Dongguk University Ilsan Hospital, South Korea; Department of Internal Medicine, Dongguk University College of Medicine, South Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University College of Medicine, South Korea
| | - Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, South Korea; Department of Software Convergence, Soonchunhyang University Graduate School, Asan, South Korea
| | - Ejin Kim
- Institute of Health and Environment, Seoul National University, South Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University College of Medicine, South Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, South Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, South Korea.
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, South Korea; Department of Public Health Science, School of Public Health, Seoul National University, South Korea.
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Lu RXZ, Radisic M. Organ-on-a-chip platforms for evaluation of environmental nanoparticle toxicity. Bioact Mater 2021; 6:2801-2819. [PMID: 33665510 PMCID: PMC7900603 DOI: 10.1016/j.bioactmat.2021.01.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 02/07/2023] Open
Abstract
Despite showing a great promise in the field of nanomedicine, nanoparticles have gained a significant attention from regulatory agencies regarding their possible adverse health effects upon environmental exposure. Whether those nanoparticles are generated through intentional or unintentional means, the constant exposure to nanomaterials can inevitably lead to unintended consequences based on epidemiological data, yet the current understanding of nanotoxicity is insufficient relative to the rate of their emission in the environment and the lack of predictive platforms that mimic the human physiology. This calls for a development of more physiologically relevant models, which permit the comprehensive and systematic examination of toxic properties of nanoparticles. With the advancement in microfabrication techniques, scientists have shifted their focus on the development of an engineered system that acts as an intermediate between a well-plate system and animal models, known as organ-on-a-chips. The ability of organ-on-a-chip models to recapitulate in vivo like microenvironment and responses offers a new avenue for nanotoxicological research. In this review, we aim to provide overview of assessing potential risks of nanoparticle exposure using organ-on-a-chip systems and their potential to delineate biological mechanisms of epidemiological findings.
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Affiliation(s)
- Rick Xing Ze Lu
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Milica Radisic
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON, Canada
- Toronto General Research Institute, University Health Network, Toronto, ON, Canada
- The Heart and Stroke/Richard Lewar Centre of Excellence, Toronto, ON, Canada
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40
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Divyaveer S, Jha V. COVID-19 and care for patients with chronic kidney disease: Challenges and lessons. FASEB Bioadv 2021; 3:569-576. [PMID: 34230909 PMCID: PMC8250957 DOI: 10.1096/fba.2021-00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has blurred the traditional distinction between communicable diseases (CD) and noncommunicable diseases (NCDs). The manifestations of COVID-19 range from an asymptomatic carrier state to fatal multiorgan failure. While initial reports did not report significant effects on the kidneys, it is now well established that kidney involvement (acute kidney injury, urinary abnormalities, tubular function defects) in COVID-19 is common and it is also associated with poorer outcomes. At the same time, care for patients with existing chronic kidney disease (CKD) has suffered during this pandemic and those with CKD are considered to have higher risk for severity of COVID-19 symptoms. Widespread lockdowns have affected the delivery of health care to patients with CKD, including those on dialysis or on transplant wait-lists. The pandemic has reinforced the need for accessible home-based therapies and highlighted the value of teleconsultation and remote monitoring technologies. COVID-19 has revealed the poor emergency preparedness by health systems around the world. It has underscored glaring inequities in availability of diagnostic tests and essential medications, including that for dialysis. In response, there has been increasing recognition of the necessity of universal health coverage and in prioritizing vaccine distribution to serve the most vulnerable, including those with kidney failure. The COVID-19 pandemic has also reaffirmed the role of the environment and eco-systems contributing to both CDs and NCDs. Attention to universal health coverage through a One Health approach is needed to prevent global health crises and prevent further kidney dysfunction and failure.
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Affiliation(s)
- Smita Divyaveer
- Department of NephrologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Vivekanand Jha
- George Institute for Global Health, UNSWNew DelhiIndia
- School of Public Health, Faculty of MedicineImperial CollegeLondonUK
- Prasanna School of Public HealthManipal Academy of Higher EducationManipalIndia
- International Society of NephrologyBrusselsBelgium
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41
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McKinley JM, Mueller U, Atkinson PM, Ofterdinger U, Cox SF, Doherty R, Fogarty D, Egozcue JJ, Pawlowsky-Glahn V. Chronic kidney disease of unknown origin is associated with environmental urbanisation in Belfast, UK. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:2597-2614. [PMID: 32583129 PMCID: PMC8275563 DOI: 10.1007/s10653-020-00618-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/08/2020] [Indexed: 05/02/2023]
Abstract
Chronic kidney disease (CKD), a collective term for many causes of progressive renal failure, is increasing worldwide due to ageing, obesity and diabetes. However, these factors cannot explain the many environmental clusters of renal disease that are known to occur globally. This study uses data from the UK Renal Registry (UKRR) including CKD of uncertain aetiology (CKDu) to investigate environmental factors in Belfast, UK. Urbanisation has been reported to have an increasing impact on soils. Using an urban soil geochemistry database of elemental concentrations of potentially toxic elements (PTEs), we investigated the association of the standardised incidence rates (SIRs) of both CKD and CKD of uncertain aetiology (CKDu) with environmental factors (PTEs), controlling for social deprivation. A compositional data analysis approach was used through balances (a special class of log contrasts) to identify elemental balances associated with CKDu. A statistically significant relationship was observed between CKD with the social deprivation measures of employment, income and education (significance levels of 0.001, 0.01 and 0.001, respectively), which have been used as a proxy for socio-economic factors such as smoking. Using three alternative regression methods (linear, generalised linear and Tweedie models), the elemental balances of Cr/Ni and As/Mo were found to produce the largest correlation with CKDu. Geogenic and atmospheric pollution deposition, traffic and brake wear emissions have been cited as sources for these PTEs which have been linked to kidney damage. This research, thus, sheds light on the increasing global burden of CKD and, in particular, the environmental and anthropogenic factors that may be linked to CKDu, particularly environmental PTEs linked to urbanisation.
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Affiliation(s)
- Jennifer M McKinley
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland.
| | - Ute Mueller
- School of Science, Edith Cowan University, Perth, WA, Australia
| | - Peter M Atkinson
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - Ulrich Ofterdinger
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland
| | - Siobhan F Cox
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland
| | - Rory Doherty
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland
| | | | - J J Egozcue
- Department of Civil and Environmental Engineering, U. Politécnica de Cataluña (UPC), Barcelona, Spain
| | - V Pawlowsky-Glahn
- Department of Computer Sciences, Applied Mathematics, and Statistics, University of Girona, Girona, Spain
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42
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Pang KL, Ekeuku SO, Chin KY. Particulate Air Pollution and Osteoporosis: A Systematic Review. Risk Manag Healthc Policy 2021; 14:2715-2732. [PMID: 34194253 PMCID: PMC8238075 DOI: 10.2147/rmhp.s316429] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
Air pollution is associated with inflammation and oxidative stress, which predispose to several chronic diseases in human. Emerging evidence suggests that the severity and progression of osteoporosis are directly associated with inflammation induced by air pollutants like particulate matter (PM). This systematic review examined the relationship between PM and bone health or fractures. A comprehensive literature search was conducted from January until February 2021 using the PubMed, Scopus, Web of Science, Google Scholar and Cochrane Library databases. Human cross-sectional, cohort and case-control studies were considered. Of the 1500 papers identified, 14 articles were included based on the inclusion and exclusion criteria. The air pollution index investigated by most studies were PM2.5 and PM10. Current studies demonstrated inconsistent associations between PM and osteoporosis risk or fractures, which may partly due to the heterogeneity in subjects' characteristics, study design and analysis. In conclusion, there is an inconclusive relationship between osteoporosis risk and fracture and PM exposures which require further validation.
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Affiliation(s)
- Kok-Lun Pang
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Sophia Ogechi Ekeuku
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
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43
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Szyszkowicz M, Schoen S, de Angelis N. Air Pollution and Emergency Department Visits for Disease of the Genitourinary System. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211025360. [PMID: 34188483 PMCID: PMC8212373 DOI: 10.1177/11786302211025360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/27/2021] [Indexed: 05/24/2023]
Abstract
The aim of this study is to determine associations between ambient air pollution and the number of emergency department (ED) visits for diseases of the genitourinary tract in Toronto, Canada. We used the National Ambulatory Care Reporting System (NACRS) database to obtain the related ED visits and developed statistical models using daily data on ED visits, temperature, relative humidity, and outdoor air pollution concentration levels. The NACRS database contains data on hospital-based and community-based ambulatory care. The environmental data were retrieved from the National Air Pollution Surveillance (NAPS) program. The NAPS is the main source of ambient air quality data in Canada. We considered 2 air quality health indexes and 6 air pollutants: daily means of fine particulate matter PM2.5, O3, CO, NO2, SO2, and also maximum 8-hour average ozone. For every air pollutant, we fit 270 models (15 lags × 18 strata). We found that same-day air pollution concentrations have the highest number of statistically significantly positive associations with ED visits for genitourinary health outcomes. A total of 133 positive associations were identified over the 14 days lag. In subgroup (strata) analysis, females older than 60 years of age were found to have the most positive associations. In particular, nitrogen dioxide was found to be highly associated with ED visits for females over 60; an increase in NO2 was associated with an increased relative risk (RR) of ED visits when lagged over 0, 1, and 2 days (RR = 1.040 [95% confidence interval: 1.028, 1.052], 1.020 [1.009, 1.032], and 1.025 [1.013, 1.036], respectively). The values of risks are reported for a 1 interquartile range increase in concentration (8.8 ppb). Our results suggest that urban ambient air pollution affect the number of ED visits due to genitourinary system conditions.
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Affiliation(s)
| | - Stephanie Schoen
- Environmental Health Science and
Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Nicholas de Angelis
- Biomedical Program, Department of
Mechanical and Aerospace Engineering, Carleton University, Ottawa, ON, Canada
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Wei KY, Liao CY, Chung CH, Lin FH, Tsao CH, Sun CA, Lu KC, Chien WC, Wu CC. Carbon Monoxide Poisoning and Chronic Kidney Disease Risk: A Nationwide, Population-Based Study. Am J Nephrol 2021; 52:292-303. [PMID: 33887746 DOI: 10.1159/000515383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/20/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Patients with carbon monoxide poisoning (COP) commonly have long-term morbidities. However, it is not known whether patients with COP exhibit an increased risk of developing chronic kidney disease (CKD) and whether hyperbaric oxygen therapy (HBOT) alters this risk. METHODS This study identified 8,618 patients who survived COP and 34,464 propensity score-matched non-COP patients from 2000 to 2013 in a nationwide administrative registry. The primary outcome was the development of CKD. The association between COP and the risk of developing CKD was estimated using a Cox proportional hazards regression model; the cumulated incidence of CKD among patients stratified by HBOT was evaluated using a Kaplan-Meier analysis. RESULTS After adjusting for covariates, the risk of CKD was 6.15-fold higher in COP patients than in non-COP controls. Based on the subgroup analyses, regardless of demographic characteristics, environmental factors, and comorbidities, the COP cohort exhibited an increased risk of developing CKD compared with the controls. The cumulative incidence of CKD in COP patients did not differ between the HBOT and non-HBOT groups (p = 0.188). CONCLUSIONS COP might be an independent risk factor for developing CKD. Thus, clinicians should enhance the postdischarge follow-up of kidney function among COP patients.
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Affiliation(s)
- Kuang-Yu Wei
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Chen-Yi Liao
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Huei Tsao
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Kuo-Cheng Lu
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Wu-Chien Chien
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Chao Wu
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Microbiology & Immunology, National Defense Medical Center, Taipei, Taiwan
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International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Eastern and Central Europe. Kidney Int Suppl (2011) 2021; 11:e24-e34. [PMID: 33981468 DOI: 10.1016/j.kisu.2021.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/09/2020] [Accepted: 01/06/2021] [Indexed: 11/21/2022] Open
Abstract
Provision of adequate kidney care for patients with chronic kidney disease or kidney failure (KF) is costly and requires extensive resources. There is an inequality in the global distribution of wealth and resources needed to provide this care. In this second iteration of the International Society of Nephrology Global Kidney Health Atlas, we present data for countries in Eastern and Central Europe. In the region, the median prevalence of chronic kidney disease was 13.15% and treated KF was 764 per million population, respectively, slightly higher than the global median of 759 per million population. In most countries in the region, over 90% of dialysis patients were on hemodialysis and patients with a functioning graft represented less than one-third of total patients with treated KF. The median annual costs for maintenance hemodialysis were close to the global median, and public funding provided nearly universal coverage of the costs of kidney replacement therapy. Nephrologists were primarily responsible for KF care. All countries had the capacity to provide long-term hemodialysis, and 95% had the capacity to provide peritoneal dialysis. Home hemodialysis was generally not available. Kidney transplantation and conservative care were available across most of the region. Almost all countries had official dialysis and transplantation registries. Eastern and Central Europe is a region with a high burden of chronic kidney disease and variable capacity to deal with it. Insufficient funding and workforce shortages coupled with increasing comorbidities among aging patients and underutilization of cost-effective dialysis therapies such as peritoneal dialysis and kidney transplantation may compromise the quality of care for patients with KF. Some workforce shortages could be addressed by improving the organization of nephrological care in some countries of the region.
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Ye JJ, Wang SS, Fang Y, Zhang XJ, Hu CY. Ambient air pollution exposure and risk of chronic kidney disease: A systematic review of the literature and meta-analysis. ENVIRONMENTAL RESEARCH 2021; 195:110867. [PMID: 33582130 DOI: 10.1016/j.envres.2021.110867] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/07/2021] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
Ambient air pollution has been identified as one of the leading causes of global burden of disease. The relationship between ambient air pollution exposure and risk of chronic kidney disease (CKD) has stimulated increasing scientific interest in the past few years. However, evidence from human epidemiological studies is still limited and inconsistent. We performed an updated systematic review and meta-analysis to clarify the potential association comprehensively. Selected electronic databases were searched for related English language studies until March 1, 2020 with a final follow-up in December 31, 2020. Risk of bias assessment for individual studies were assessed using the OHAT (Office of Health Assessment and Translation) risk-of-bias rating tool. Confidence rating and level-of-evidence conclusions were developed for bodies of evidence for a given ambient air pollutant. Summary effect estimates were calculated using random-effects meta-analyses when three or more studies are identified for the same air pollutant-CKD combination. A total of 13 studies were finally identified in our study. The meta-analytic estimates (ORs) for risk of CKD were 1.15 (95% CI: 1.07, 1.24) for each 10 μg/m3 increase in PM2.5, 1.25 (95% CI: 1.11, 1.40) for each 10 μg/m3 increase in PM10, 1.10 (95% CI: 1.03, 1.17) for each 10 ppb increase in NO2, 1.06 (95% CI: 0.98, 1.15) for each 1 ppb increase in SO2 and 1.04 (95% CI: 1.00, 1.08) for each 0.1 ppm increase in CO, respectively. The level of evidence was appraised as moderate for four of the five tested air pollutant-CKD combinations using an adaptation of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool. In conclusion, this study suggests that certain ambient air pollutant exposure was significantly associated with an increased risk of CKD. Given the limitations, the results of this study should be interpreted with caution, and further well-designed epidemiological studies are needed to draw a definite evidence of a causal relationship.
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Affiliation(s)
- Jia-Jia Ye
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Shu-Si Wang
- Department of Healthcare-associated Infection Management, Hefei Stomatological Hospital, Anhui Medical University Hefei Oral Clinic College, 265 Changjiang Middle Road, Hefei, 230001, China
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA Rotterdam, the Netherlands
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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47
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Feng Y, Jones MR, Chu NM, Segev DL, McAdams-DeMarco M. Ambient Air Pollution and Mortality among Older Patients Initiating Maintenance Dialysis. Am J Nephrol 2021; 52:217-227. [PMID: 33789279 DOI: 10.1159/000514233] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fine particulate matter (particulate matter with diameter <2.5 µm [PM2.5]) is associated with CKD progression and may impact the health of patients living with kidney failure. While older (aged ≥65 years) adults are most vulnerable to the impact of PM2.5, it is unclear whether older patients on dialysis are at elevated risk of mortality when exposed to fine particulate matter. METHODS Older adults initiating dialysis (2010-2016) were identified from US Renal Data System (USRDS). PM2.5 concentrations were obtained from NASA's Socioeconomic Data and Application Center (SEDAC) Global Annual PM2.5 Grids. We investigated the association between PM2.5 and all-cause mortality using Cox proportional hazard models with linear splines [knot at the current Environmental Protection Agency (EPA) National Ambient Air Quality Standard for PM2.5 of 12 μg/m3] and robust variance. RESULTS For older dialysis patients who resided in areas with high PM2.5, a 10 μg/m3 increase in PM2.5 was associated with 1.16-fold (95% CI: 1.08-1.25) increased risk of mortality; furthermore, those who were female (aHR = 1.26, 95% CI: 1.13-1.42), Black (aHR = 1.31, 95% CI: 1.09-1.59), or had diabetes as a primary cause of kidney failure (aHR = 1.25, 95% CI: 1.13-1.38) were most vulnerable to high PM2.5. While the mortality risk associated with PM2.5 was stronger at higher levels (aHR = 1.19, 95% CI: 1.08-1.32), at lower levels (≤12 μg/m3), PM2.5 was significantly associated with mortality risk (aHR = 1.04, 95% CI: 1.00-1.07) among patients aged ≥75 years (Pslope difference = 0.006). CONCLUSIONS Older adults initiating dialysis who resided in ZIP codes with PM2.5 levels >12 μg/m3 are at increased risk of mortality. Those aged >75 were at elevated risk even at levels below the EPA Standard for PM2.5.
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Affiliation(s)
- Yijing Feng
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nadia M Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mara McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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48
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Tsai HJ, Hung CH, Wang CW, Tu HP, Li CH, Tsai CC, Lin WY, Chen SC, Kuo CH. Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease. Diagnostics (Basel) 2021; 11:diagnostics11020282. [PMID: 33670331 PMCID: PMC7918558 DOI: 10.3390/diagnostics11020282] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The prevalence of chronic kidney disease (CKD) is increasing annually in Taiwan. In addition to traditional risk factors, heavy metals contribute to the development of CKD. The aim of this study was to investigate associations among heavy metals and proteinuria and CKD in the general population in Southern Taiwan. We also explored the interaction and synergetic effects among heavy metals on proteinuria. Methods: We conducted a health survey in the general population living in Southern Taiwan between June 2016 and September 2018. Seven heavy metals were measured: blood lead (Pb) and urine nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), copper (Cu), and cadmium (Cd). Proteinuria was measured using reagent strips. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Results: The mean age of the 2447 participants was 55.1 ± 13.2 years and included 977 males and 1470 females. Participants with high blood Pb and high urine Ni, Mn, Cu, and Cd were significantly associated with proteinuria. Interactions between blood Pb and urine Cr, and between urine Cd and Cu, had significant effects on proteinuria. The participants with high blood Pb and high urine Cu were significantly associated with an eGFR of <60 mL/min/1.73 m2. Conclusion: High blood Pb and high urine Cu may be associated with proteinuria and an eGFR of <60 mL/min/1.73 m2. High urine Ni, Mn, and Cd were significantly associated with proteinuria. Co-exposure to Cd and Cu, and Pb and Cr, may have synergistic effects on proteinuria.
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Affiliation(s)
- Hui-Ju Tsai
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan;
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-H.H.); (W.-Y.L.)
| | - Chih-Hsing Hung
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-H.H.); (W.-Y.L.)
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (C.-W.W.); (C.-H.K.)
- Department of Internal Medicine, Division of Hepatobiliary, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Chiu-Hui Li
- Health Management and Occupational Safety Health Center, Kaohsiung Municipal Siaogang Hospital; Kaohsiung 812, Taiwan; (C.-H.L.); (C.-C.T.)
| | - Chun-Chi Tsai
- Health Management and Occupational Safety Health Center, Kaohsiung Municipal Siaogang Hospital; Kaohsiung 812, Taiwan; (C.-H.L.); (C.-C.T.)
| | - Wen-Yi Lin
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-H.H.); (W.-Y.L.)
- Department of Internal Medicine, Division of Hepatobiliary, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Health Management and Occupational Safety Health Center, Kaohsiung Municipal Siaogang Hospital; Kaohsiung 812, Taiwan; (C.-H.L.); (C.-C.T.)
| | - Szu-Chia Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-H.H.); (W.-Y.L.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (C.-W.W.); (C.-H.K.)
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-8036783 (ext. 3440); Fax: +886-7-8063346
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (C.-W.W.); (C.-H.K.)
- Department of Internal Medicine, Division of Gastroenterology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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49
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Blankestijn PJ, Bruchfeld A, Cozzolino M, Fliser D, Fouque D, Gansevoort R, Goumenos D, Massy ZA, Rychlık I, Soler MJ, Stevens K, Zoccali C. Nephrology: achieving sustainability. Nephrol Dial Transplant 2021; 35:2030-2033. [PMID: 32901289 DOI: 10.1093/ndt/gfaa193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/20/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Peter J Blankestijn
- Department of Nephrology, University Medical Center, Utrecht, The Netherlands
| | - Annette Bruchfeld
- Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Health, Medicine and Caring Sciences, Stockholm and Division of Diagnostics and Specialist Medicine, Linköping University, Linköping, Sweden
| | - Mario Cozzolino
- Department of Health Sciences, University of Milan, Renal Division, ASST Santi Paolo e Carlo, Milan, Italy
| | - Danilo Fliser
- Internal Medicine IV, Renal and Hypertensive Disease, University Medical Center, Homburg, Saar, Germany
| | - Denis Fouque
- Department of Nephrology, Dialysis, Nutrition, Centre Hospitalier Lyon Sud, Pierre Benite Cedex, France
| | - Ron Gansevoort
- Department of Nephrology, University Medical Centre Groningen, University Hospital Groningen, Groningen, The Netherlands
| | - Dimitrios Goumenos
- Department of Nephrology and Renal Transplantation, Patras University Hospital, Patras, Greece
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt/Paris, France.,Centre for Research in Epidemiology and Population Health (CESP), INSERM UMRS 1018, Université Paris-Saclay, Université Versailles Saint Quentin (UVSQ), Villejuif, France
| | - Ivan Rychlık
- 1st Department of Internal Medicine, Third Faculty of Medicine, Charles University, Faculty Hospital Královské Vinohrady, Prague, Czech Republic
| | - Maria Jose Soler
- Department Nephrology, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Nephrology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Kate Stevens
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
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Hamroun A, Camier A, Bigna JJ, Glowacki F. Impact of air pollution on renal outcomes: a systematic review and meta-analysis protocol. BMJ Open 2021; 11:e041088. [PMID: 33455930 PMCID: PMC7813312 DOI: 10.1136/bmjopen-2020-041088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Chronic kidney disease is a serious and a frequent disease associated with a high risk of morbi-mortality. Although several risk factors have already been well addressed, mostly diabetes and hypertension, many remain underappreciated, such as chronic exposure to air pollution. METHODS AND ANALYSIS We will search EMBASE, PubMed, Web of Science, Cochrane Library and CINAHL database, from inception to 31 March 2020, for relevant records using a combination of keywords related to the type of exposure (ozone, carbon monoxide, nitrogen oxides and dioxide, sulfur dioxide, PM2.5, PMcoarse and PM10) and to the type of outcome (chronic kidney disease, end-stage renal/kidney disease, kidney failure, proteinuria/albuminuria, renal function, renal transplant, kidney graft, kidney transplant failure, nephrotic syndrome and kidney cancer). The review will be reported according to the guidelines of the Meta-analysis Of Observational Studies in Epidemiology. Two independent reviewers will select studies without design or language restrictions, using original data and investigating the association between exposure to one or more of the prespecified air pollutants and subsequent risk of renal outcomes. Using random-effects meta-analyses, we will present pooled summary statistics (HR, OR or beta-coefficients with their respective 95% CI) associated with a standardised increase in each pollutant level. The results will be presented by air pollutant and outcome. Heterogeneity will be assessed using the χ2 test on Cochran's Q statistic and quantified by calculating I2. The Egger's test and visual inspection of funnel plots will be used to assess publication bias. ETHICS AND DISSEMINATION Since primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the associations between various air pollutants' exposure and renal outcomes. The final report will be published in an international peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020187956.
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Affiliation(s)
- Aghilès Hamroun
- Nephrology, Regional and University Hospital Centre Lille, Lille, France
- Clinical Epidemiology Team, INSERM U1018, Villejuif, France
| | - Aurore Camier
- Research Team on Early Life Origins of Health (EAROH), UMR1153 Centre of Research in Epidemiology and Statistics (CRESS), Paris, France
| | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - François Glowacki
- Nephrology, Regional and University Hospital Centre Lille, Lille, France
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