Effect of modification of antihypertensive medications on the association of nitrogen dioxide long-term exposure and chronic kidney disease.
- Author:
Lin MA
1
;
Jing Yi WU
2
;
Shuang Cheng LI
3
;
Peng Fei LI
2
;
Lu Xia ZHANG
2
Author Information
1. Office of Development Planning and Academic Development, Peking University, Beijing 100191, China.
2. Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China.
3. Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China.
- Publication Type:Journal Article
- Keywords:
Antihypertensive agents;
Chronic kidney disease;
Effect modification;
Nitrogen dioxide
- MeSH:
Adult;
Air Pollutants/analysis*;
Air Pollution/analysis*;
Antihypertensive Agents/adverse effects*;
Environmental Exposure/analysis*;
Humans;
Hypertension/epidemiology*;
Middle Aged;
Nitrogen Dioxide/analysis*;
Particulate Matter;
Renal Insufficiency, Chronic/epidemiology*
- From:
Journal of Peking University(Health Sciences)
2022;54(5):1047-1055
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the potential effect of modification of antihypertensive medications on the association of nitrogen dioxide (NO2) long-term exposure and chronic kidney disease (CKD).
METHODS:Data of the national representative sample of adult population from the China National Survey of Chronic Kidney Disease (2007-2010) were included in the analyses, and exposure data of NO2 were collected and matched. Generalized mixed-effects models were used to analyze the associations between NO2 and CKD, stratified by the presence of hypertension and taking antihypertensive medications. The stratified exposure-response curves of NO2 and CKD were fitted using the natural spine smoothing function. The modifying effects of antihypertensive medications on the association and the exposure-response curve of NO2 and CKD were analyzed.
RESULTS:Data of 45 136 participants were included, with an average age of (49.5±15.3) years. The annual average exposure concentration of NO2 was (7.2±6.4) μg/m3. Altogether 6 517 (14.4%) participants were taking antihypertensive medications, and 4 833 (10.7%) participants were identified as having CKD. After adjustment for potential confounders, in the hypertension population not using antihypertensive medications, long-term exposure to NO2 was associated with a significant increase risk of CKD (OR: 1.38, 95%CI: 1.24-1.54, P < 0.001); while in the hypertension population using antihypertensive medications, no significant association between long-term exposure to NO2 and CKD (OR: 0.96, 95%CI: 0.86-1.07, P=0.431) was observed. The exposure-response curve of NO2 and CKD suggested that there was a non-linear trend in the association between NO2 and CKD. The antihypertension medications showed significant modifying effects both on the association and the exposure-response curve of NO2 and CKD (interaction P < 0.001).
CONCLUSION:The association between long-term exposure to NO2 and CKD was modified by antihypertensive medications. Taking antihypertensive medications may mitigate the effect of long-term exposure to NO2 on CKD.
