Long-term Particulate Matter Exposure Increases the Mortality Risk of Patients with End-Stage Renal Disease

TPS 682: Long-term health effects of air pollutants 2, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM Background: Recent studies have identified the effect of particular matter (PM) on kidney which filters toxic substances. However, little is known for relationship between PM and mortality of end-stage renal disease (ESRD). Methods: We collected ESRD patients who have been dialyzed from 2008 to 2015 in CRC cohort. PM10 was assigned to each patients based on sido of hospital where patients have received dialysis continuously. We used time-varying Cox proportional hazard model including every 3-years PM10, age, sex, smoking and marital status, education, social and family support, and insurance as well as regional variables to identify hazard ratios (HRs) of mortality when exposed to PM10. Stratified analysis was also conducted by potential confounders. Results: During the follow-up (mean 4.18 years), 1475 deaths occurred among 5041 participants. We found non-linear relationship between mortality of ESRD patients and PM10, showing threshold at 44.15μg/m3. HRs and 95% confidence interval of lower and upper section than threshold were 0.71 (0.69, 0.74) and 1.25 (1.22, 1.28), respectively. Those who married and highly educated were at high risk in both sections, but opposite tendency was shown in each sections when stratified by population density, family and social support and the number of institutions. Conclusions: We found that patients with ESRD were affected differently by long-term PM10 concentrations. It may be caused by toxicity of PM and characteristics of behavior at relatively low concentration. Further researches were needed to identify characteristics in lower group.