Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study
Abstract Background Epidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD. Methods We included 61,073...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-02-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-024-03500-6 |
| _version_ | 1827328279651024896 |
|---|---|
| author | Ejin Kim Hyuk Huh Yongwon Mo Jae Yoon Park Jiyun Jung Hajeong Lee Sejoong Kim Dong Ki Kim Yon Su Kim Chun Soo Lim Jung Pyo Lee Yong Chul Kim Ho Kim |
| author_facet | Ejin Kim Hyuk Huh Yongwon Mo Jae Yoon Park Jiyun Jung Hajeong Lee Sejoong Kim Dong Ki Kim Yon Su Kim Chun Soo Lim Jung Pyo Lee Yong Chul Kim Ho Kim |
| author_sort | Ejin Kim |
| collection | DOAJ |
| description | Abstract Background Epidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD. Methods We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed. Results In the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3. The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014–1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035–1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044–1.054) at the district unit and 1.04 (95%CI: 1.031–1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008–1.017) for administrative districts and 1.04 (95% confidence interval: 1.031–1.05) for individual addresses. Conclusions This study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment. |
| first_indexed | 2024-03-07T15:15:08Z |
| format | Article |
| id | doaj.art-8e4e0caaacdd4bd8bee16ec4186c6bc3 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-07T15:15:08Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-8e4e0caaacdd4bd8bee16ec4186c6bc32024-03-05T17:57:08ZengBMCBMC Nephrology1471-23692024-02-0125111110.1186/s12882-024-03500-6Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort studyEjin Kim0Hyuk Huh1Yongwon Mo2Jae Yoon Park3Jiyun Jung4Hajeong Lee5Sejoong Kim6Dong Ki Kim7Yon Su Kim8Chun Soo Lim9Jung Pyo Lee10Yong Chul Kim11Ho Kim12Institute of Health and Environment and Graduate School of Public Health, Seoul National UniversityDepartment of Internal Medicine, Inje University Busan Paik HospitalDepartment of Landscape Architecture, Yeungnam UniversityDepartment of Internal Medicine, Dongguk University Ilsan HospitalData Management and Statistics Institute, Dongguk University Ilsan HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University Bundang HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University Boramae Medical CenterDepartment of Internal Medicine, Seoul National University Boramae Medical CenterDepartment of Internal Medicine, Seoul National University HospitalInstitute of Health and Environment and Graduate School of Public Health, Seoul National UniversityAbstract Background Epidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD. Methods We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed. Results In the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3. The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014–1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035–1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044–1.054) at the district unit and 1.04 (95%CI: 1.031–1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008–1.017) for administrative districts and 1.04 (95% confidence interval: 1.031–1.05) for individual addresses. Conclusions This study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment.https://doi.org/10.1186/s12882-024-03500-6Chronic kidney diseaseEnd stage renal diseaseMortalityOzone |
| spellingShingle | Ejin Kim Hyuk Huh Yongwon Mo Jae Yoon Park Jiyun Jung Hajeong Lee Sejoong Kim Dong Ki Kim Yon Su Kim Chun Soo Lim Jung Pyo Lee Yong Chul Kim Ho Kim Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study BMC Nephrology Chronic kidney disease End stage renal disease Mortality Ozone |
| title | Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study |
| title_full | Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study |
| title_fullStr | Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study |
| title_full_unstemmed | Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study |
| title_short | Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study |
| title_sort | long term ozone exposure and mortality in patients with chronic kidney disease a large cohort study |
| topic | Chronic kidney disease End stage renal disease Mortality Ozone |
| url | https://doi.org/10.1186/s12882-024-03500-6 |
| work_keys_str_mv | AT ejinkim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT hyukhuh longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT yongwonmo longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT jaeyoonpark longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT jiyunjung longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT hajeonglee longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT sejoongkim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT dongkikim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT yonsukim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT chunsoolim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT jungpyolee longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT yongchulkim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy AT hokim longtermozoneexposureandmortalityinpatientswithchronickidneydiseasealargecohortstudy |