Kidney Week

Abstract: SA-PO1060

Long-Term Effect of Particulate Matter on Mortality Risk of Patients with ESRD

Session Information

• Hemodialysis and Frequent Dialysis - VI
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Park, Jae Yoon, Dongguk University Ilsan Hospital, Gyeonggido, Korea (the Republic of)

Jae Yoon Park,

• Jung, Jiyun, Seoul National University, Seoul, Korea (the Republic of)

Jiyun Jung,

• Kim, Yong Chul, SNUH, Seoul, Korea (the Republic of)

Yong Chul Kim,

• Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yon Su Kim,

• Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)

Jung Pyo Lee,

• Kim, Ho, Seoul National University, Seoul, Korea (the Republic of)

Ho Kim,

Background

Aerodynamic particulate matter (PM) significantly worsens morbidity and mortality in various diseases, especially in cardiovascular and pulmonary diseases. However, little is known for relationship between PM and mortality of end-stage renal disease (ESRD).

Methods

5041 patients who began dialysis from August 2008 to February 2015 were prospectively enrolled in the Clinical Research Center for End-Stage Renal Disease cohort study. We assigned daily mean concentration of PM < 10 μm in aerodynamic diameter (PM₁₀) to each participants for provincial-level divisions (si-do) by the location of station. Time-varying Cox proportional hazard models were used to investigate the relationship between PM₁₀ and mortality of ESRD patients who have received dialysis. Stratified analysis was also conducted by potential confounders such as age, sex, smoking status, education, insurance, marital status, and social and familial support.

Results

During the follow-up period (mean 4.18 years), 1475 deaths occurred among 5041 participants. We found non-linear relationship between PM₁₀ and mortality. Based on a threshold level at 44.15μg/m³, although lower PM₁₀ group had higher HRs for mortality with decrease in PM₁₀ (HR 0.71, CI 0.69-0.74), higher PM₁₀ group had higher HRs with increase in PM₁₀ (HR 1.25, CI 1.22-1.28). Those who married and highly educated were at high risk in both groups, but opposite tendency was shown in each groups when stratified by population density, family and social support and the number of hospitals.

Conclusion

We found that the mortality of ESRD patients has contrary effects based on a threshold level of PM₁₀. It may be caused by toxicity of PM and characteristics of behavior at the region with relatively low concentration of PM₁₀.