Long-Term Effects of Air Pollutants on Mortality Risk in Patients with End-Stage Renal Disease

Jiyun Jung, Jae Yoon Park, Yong Chul Kim, Hyewon Lee, Ejin Kim, Yong-Lim Kim, Yon Su Kim, Jung Pyo Lee, Ho Kim and Clinical Research Center for End-Stage Renal Disease (CRC for ESRD) Investigators
Additional contact information
Jiyun Jung: Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, Seoul 08826, Korea
Jae Yoon Park: Department of Internal Medicine, Dongguk University Ilsan Hospital, Gyeonggi-do 10326, Korea
Yong Chul Kim: Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
Hyewon Lee: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Korea
Ejin Kim: Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, Seoul 08826, Korea
Yong-Lim Kim: Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu 41566, Korea
Yon Su Kim: Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
Jung Pyo Lee: Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
Ho Kim: Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, Seoul 08826, Korea
Clinical Research Center for End-Stage Renal Disease (CRC for ESRD) Investigators: These authors are mentioned in Acknowledgments.

IJERPH, 2020, vol. 17, issue 2, 1-12

Abstract: Long-term exposure to air pollutants significantly increases the morbidity and mortality associated with various diseases. However, little is known about the relationship between air pollutants and end-stage renal disease (ESRD)-related mortality. A total of 5041 patients who started dialysis between 2008 and 2015 were prospectively enrolled in the Clinical Research Center for End-Stage Renal Disease (CRC-ESRD) cohort study. We assigned a daily mean concentration of air pollutants (PM 10 , NO 2 , and SO 2 ) to each participant. Time-varying Cox models were used to investigate the relationship between air pollutants and mortality in ESRD patients. During the follow-up period (mean 4.18 years), 1475 deaths occurred among 5041 participants. We found a significant long-term relationship between mortality risk and PM 10 (HR 1.33, CI 1.13–1.58), NO 2 (HR 1.46, CI 1.10–1.95), and SO 2 (HR 1.07, CI 1.03–1.11). Elderly patients and patients who lived in metropolitan areas had an increased risk associated with PM 10 . Elderly patients also had increased risks associated NO 2 and SO 2 . Long-term exposure to air pollutants had negative effects on mortality in ESRD patients. These effects were prominent in elderly patients who lived in metropolitan areas, suggesting that ambient air pollution, in addition to traditional risk factors, is important for the survival of these patients.

Keywords: particulate matter; nitrogen dioxide; sulfur dioxide; ESRD; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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