TY - JOUR
T1 - Ambient carbon monoxide correlates with mortality risk of hemodialysis patients
T2 - comparing results of control selection in the case-crossover designs
AU - Huh, Hyuk
AU - Kim, Ejin
AU - Yoon, Una Amelia
AU - Choi, Mun Jeong
AU - Lee, Hyewon
AU - Kwon, Soie
AU - Kim, Clara Tammy
AU - Kim, Dong Ki
AU - Kim, Yon Su
AU - Lim, Chun Soo
AU - Lee, Jung Pyo
AU - Kim, Ho
AU - Kim, Yong Chul
N1 - Publisher Copyright:
© 2022 by The Korean Society of Nephrology.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Growing evidence suggests that environmental air pollution adversely affects kidney health. To date, the association between carbon monoxide (CO) and mortality in patients with end-stage renal disease (ESRD) has not been examined. Methods: Among 134,478 dialysis patients in the Korean ESRD cohort between 2001 and 2014, 8,130 deceased hemodialysis patients were enrolled, and data were analyzed using bidirectional, unidirectional, and time-stratified case-crossover design. We examined the association between short-term CO concentration and mortality in patients with ESRD. We used a two-pollutant model, adjusted for temperature as a climate factor and for nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter less than 10 μm in diameter as air pollution variables other than CO. Results: Characteristics of the study population included age (66.2 ± 12.1 years), sex (male, 59.1%; female, 40.9%), and comorbidi-ties (diabetes, 55.6%; hypertension, 14.4%). Concentration of CO was significantly associated with all-cause mortality in the three case-crossover designs using the two-pollutant model adjusted for SO2. Patients with diabetes or age older than 75 years had a higher risk of mortality than patients without diabetes or those younger than 75 years. Conclusion: Findings presented here suggest that higher CO concentration is correlated with increased all-cause mortality in hemodi-alysis patients, especially in older high-risk patients.
AB - Background: Growing evidence suggests that environmental air pollution adversely affects kidney health. To date, the association between carbon monoxide (CO) and mortality in patients with end-stage renal disease (ESRD) has not been examined. Methods: Among 134,478 dialysis patients in the Korean ESRD cohort between 2001 and 2014, 8,130 deceased hemodialysis patients were enrolled, and data were analyzed using bidirectional, unidirectional, and time-stratified case-crossover design. We examined the association between short-term CO concentration and mortality in patients with ESRD. We used a two-pollutant model, adjusted for temperature as a climate factor and for nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter less than 10 μm in diameter as air pollution variables other than CO. Results: Characteristics of the study population included age (66.2 ± 12.1 years), sex (male, 59.1%; female, 40.9%), and comorbidi-ties (diabetes, 55.6%; hypertension, 14.4%). Concentration of CO was significantly associated with all-cause mortality in the three case-crossover designs using the two-pollutant model adjusted for SO2. Patients with diabetes or age older than 75 years had a higher risk of mortality than patients without diabetes or those younger than 75 years. Conclusion: Findings presented here suggest that higher CO concentration is correlated with increased all-cause mortality in hemodi-alysis patients, especially in older high-risk patients.
KW - Carbon monoxide
KW - Elderly
KW - Hemodialysis
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=85139133689&partnerID=8YFLogxK
U2 - 10.23876/j.krcp.21.228
DO - 10.23876/j.krcp.21.228
M3 - Article
AN - SCOPUS:85139133689
VL - 41
SP - 601
EP - 610
JO - Kidney Research and Clinical Practice
JF - Kidney Research and Clinical Practice
SN - 2211-9132
IS - 5
ER -