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

Chen, Shih-Feng; Chien, Yu-Hui; Chen, Pau‐Chung

doi:10.1016/j.envpol.2022.120606

Cited by 5 publications

(14 citation statements)

References 40 publications

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“…Eight studies ( n = 8) examined the effects of PM on the clinical outcomes of dialysis patients, specifically four retrospective cohort studies ( n = 4) examined patient mortality outcomes and four reported other health endpoints [19,20 ▪ ,21 ▪ ,22 ▪ ,23–26] (Table 1). A retrospective observational cohort study of 384 276 older adult dialysis patients in the U.S. Renal Data System (USRDS) observed that high annual PM 2.5 (>12 μg/m 3 ) was associated with an increased risk for mortality [20 ▪ ].…”

Section: Epidemiologic Evidence For Effects Of Particulate Matter On ...mentioning

confidence: 99%

“…In a retrospective cohort study of 314 079 adult maintenance HD patients in Taiwan, a higher short-term daily PM 2.5 concentration was associated with increased hazards of mortality [26]. In a retrospective population-based cohort study of 34 088 adult maintenance HD patients, PM 2.5 data from the Taiwan Air Quality-Monitoring Database was used to examine associations with mortality risk [19]. The study reported a 10 μg/m 3 increase in PM 2.5 was associated with up to 1.11-fold (95% CI: 1.08, 1.13) increase in mortality risk with 6.22 years of median follow-up [19].…”

Section: Epidemiologic Evidence For Effects Of Particulate Matter On ...mentioning

confidence: 99%

“…In a retrospective population-based cohort study of 34 088 adult maintenance HD patients, PM 2.5 data from the Taiwan Air Quality-Monitoring Database was used to examine associations with mortality risk [19]. The study reported a 10 μg/m 3 increase in PM 2.5 was associated with up to 1.11-fold (95% CI: 1.08, 1.13) increase in mortality risk with 6.22 years of median follow-up [19]. In a case cross-over study in China, 18 114 deaths were identified and short-term exposure to PM 2.5 and PM 10 was estimated using data from 1436 air quality monitoring stations through the National Urban Air Quality Real-Time Publishing Platform of China and air pollution exposure levels for each hospital were calculated by inverse distance weighting model [22 ▪ ].…”

Section: Epidemiologic Evidence For Effects Of Particulate Matter On ...mentioning

confidence: 99%

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Clearing the air: a review of the effects of air pollution on dialysis outcomes

Spencer,

Lavenburg,

Sanders

et al. 2024

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of review An evolving body of literature indicates exposure to air pollutants is associated with adverse health outcomes in dialysis patients. As the prevalence of kidney disease increases, understanding the role of environmental agents on the health of dialysis patients is critical to reducing global morbidity and mortality. Recent findings We identified 16 publications that investigated associations between pollutants including particulate matter (PM2.5 and PM10), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) and health outcomes among dialysis patients. Eight studies examined the effects of particulate matter (PM) and four studies examined the effects CO exposure on dialysis patients. Exposure to PM was consistently associated with outcomes including all-cause mortality and a smaller body of literature suggested relationships with subclinical outcomes. Exposure to CO was associated with all-cause mortality, generalized inflammation, and uremic pruritus. An additional four studies examined multiple pollutant exposures including NO2, SO2, and O3 and reported associations with all-cause mortality in dialysis patients. Summary This review emphasized the nascent literature that demonstrates consistent relationships between air pollutant exposure and adverse outcomes among dialysis patients. Further research is needed to assess the impact of air pollutants, including how co-exposures will impact dialysis patient health.

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Section: Epidemiologic Evidence For Effects Of Particulate Matter On ...mentioning

confidence: 99%

Section: Epidemiologic Evidence For Effects Of Particulate Matter On ...mentioning

confidence: 99%

Section: Epidemiologic Evidence For Effects Of Particulate Matter On ...mentioning

confidence: 99%

See 1 more Smart Citation

Clearing the air: a review of the effects of air pollution on dialysis outcomes

Spencer,

Lavenburg,

Sanders

et al. 2024

Current Opinion in Nephrology &Amp; Hypertension

View full text Add to dashboard Cite

show abstract

“…In addition to these challenges, Taiwan contends with high levels of air pollution, ranking fourth out of 39 OECD countries, adding another layer of concern (OECD, 2023). Despite sporadic researches demonstrating that prolonged exposure to PM2.5 is linked to adverse effects on mortality among adult dialysis patients (Feng et al, 2021;Chen et al, 2023), the specific impact of long-term PM10 exposure on the mortality of dialysis patients remains unclear.…”

Section: A C C E P T E D Mmentioning

confidence: 99%

“…Recent research has linked prolonged exposure to ambient fine particulate matter (PM2.5) with an increased risk of adverse renal outcomes, including the development and progression of CKD, the incidence of end-stage renal disease (ESRD) (Bowe et al, 2018;Chan et al, 2018;Lin et al, 2020;Wu et al, 2020;Li et al, 2021;Ghazi et al, 2022), and higher mortality in dialysis patients (Feng et al, 2021;Chen et al, 2023). Additionally, emerging studies suggest that PM10 may also have adverse effects on kidney health.…”

Section: Accepted Manuscript 1 Introductionmentioning

confidence: 99%

Associations of Long-term PM10 Exposure with Mortality in Dialysis Patients: A Population Based Cohort Study

Chen,

Chien,

Lai

et al. 2024

Aerosol Air Qual. Res.

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Exposure to PM2.5 has been observed to be associated with an increased risk of mortality in dialysis patients, while sporadic studies have hinted at the adverse effects of coarse particulate matter (PM10) on kidney health. However, the impact of PM10 on survival in end-stage renal disease patients remains unclear. To address this gap, we conducted a retrospective cohort study, linking the Taiwan Air Quality-Monitoring Database (TAQMD) with the National Health Insurance Research Database (NHIRD) based on patients' zip codes. We included 34,088 adult dialysis patients living in areas with ambient measurements of PM10, NO2, CO, and SO2 between 1 January, 2000 and 31 December, 2013. We used a multivariate Cox proportional hazards model to estimate mortality risk and observed that each interquartile range (IQR) increase in the mean PM10 concentration during follow-up period was associated with a 13.2% higher risk of mortality (adjusted hazard ratio [aHR] = 1.132, 95% confidence interval [CI] = 1.097-1.169). Even in twopollutant scenarios, the association between long-term exposure to PM10 and mortality remained significant. Spline analysis demonstrated a non-linear concentration-response relationship between PM10 and mortality, with an increase in aHR when the average PM10 exposure exceeded a threshold of 43 μg m -3 . Stratification analysis revealed that male patients had a significantly higher increase in mortality risk per IQR increase in PM10 compared to female patients (aHR 1.185 vs. 1.074; pinteraction < 0.001). Our study demonstrated a significant association between long-term ambient PM10 exposure and mortality risk among dialysis patients, especially in males. A non-linear

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