Ambient carbon monoxide correlates with mortality risk of hemodialysis patients: comparing results of controlselection in the case-crossover designs
- Author:
Hyuk HUH
1
;
Ejin KIM
;
Una Amelia YOON
;
Mun Jeong CHOI
;
Hyewon LEE
;
Soie KWON
;
Clara Tammy KIM
;
Dong Ki KIM
;
Yon Su KIM
;
Chun Soo LIM
;
Jung Pyo LEE
;
Ho KIM
;
Yong Chul KIM
Author Information
- Publication Type:Original Article
- From:Kidney Research and Clinical Practice 2022;41(5):601-610
- CountryRepublic of Korea
- Language:English
- Abstract: 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 comorbidities (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 hemodialysis patients, especially in older high-risk patients.
