Ambient Air Particulate Matter and Hospital Admissions for Chronic Kidney Disease in China:A Nationwide Case-Crossover Study  

作　　者：Juan Chen Huimeng Liu Ge Li Lijun Bai Yunxing Jiang Jinxi Wang Chen Wei Yinxiang Li Jian Lei Furong Deng Luxia Zhang Xinbiao Guo Shaowei Wu 

机构地区：[1]Department of Occupational and Environmental Health,School of Public Health,Xi’an Jiaotong University Health Science Center,Xi’an,Shaanxi 710061,China [2]Key Laboratory of Environment and Genes Related to Diseases,Ministry of Education,Xi’an,Shaanxi 710061,China [3]Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health,Xi’an,Shaanxi 710061,China [4]Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province,Xi’an,Shaanxi 710061,China [5]Shaanxi Provincial Institute for Endemic Disease Control,Xi’an,Shaanxi 710003,China [6]Yunyi Health Technology Co.Ltd.,Beijing 102629,China [7]China-Europe Association for Technical and Economic Cooperation,Beijing 101318,China [8]Renal Division,Department of Medicine,Peking University First Hospital,Peking University Institute of Nephrology,Beijing 100034,China [9]Advanced Institute of Information Technology,Peking University,Hangzhou 311200,China [10]National Institutes of Health Data Science at Peking University,Beijing 100191,China

出　　处：《Environment & Health》2024年第8期553-562,共10页环境与健康（英文）

基　　金：National Key Research and Development Program of China(grant number:2022YFC3702604 and 2022YFC3702704);Youth Top Talent Program of Xi’an Jiaotong University.

摘　　要：Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a sensitive proxy reflecting the disease burden.However,the association of PM exposure with hospital admissions for CKD is still unknown,let alone the excess risks(ERs)in hospital admissions for CKD due to high PM level exposure.In this study,a two-stage time-stratified case-crossover study was conducted to investigate the association of ambient air PM exposure with hospital admission for CKD in 282 Chinese cities of prefecture-level or above during 2013–2017.City-specific associations of single and cumulative 0–3 days lagged exposure to fine particulate matter(PM_(2.5))and inhalable particles(PM_(10))with hospital admissions for total CKD and its subtypes were evaluated by the conditional logistic regression model,then were pooled using the random-effect model.A total of 3,490,416 hospital admissions for CKD were identified.We found that per interquartile range(IQR)increment in PM_(2.5) at lag02 and per IQR increment in PM_(10) at lag03 were associated with increases of 2.36%(95%CI:1.58%,3.14%)and 2.87%(95%CI:1.91%,3.85%)in hospital admissions for total CKD,respectively.Compared to control concentrations(PM_(2.5):35μg/m^(3);PM_(10):50μg/m^(3)),the largest ERs in hospital admissions for total CKD were 2.63%(95%CI:2.15%–3.11%)and 4.45%(95%CI:3.85%–5.06%)in association with exposure to heavily excessive PM_(2.5)(≥75μg/m^(3))and PM_(10)(≥150μg/m^(3)),respectively.Moreover,the attributable fractions(AFs)for CKD admissions were 2.83%for PM_(2.5) and 3.46%for PM_(10) during the study period.These findings suggested that exposure to PM_(2.5) and PM_(10) is associated with substantially increased risk and burden of CKD admissions.

关 键 词：particulate matter hospital admission chronic kidney disease excess risks CASE-CROSSOVER 

分 类 号：R692[医药卫生—泌尿科学] X51[医药卫生—外科学]