Mortality and morbidity of chronic kidney disease associated with ambient environment in metropolitans in Taiwan

Abstract

BackgroundHealth effects associated with extreme temperature and elevated air pollutants have been concerns. The present study examined mortality from and morbidity of chronic kidney disease (CKD) associated with extreme temperature and exposure to fine particulate matter (PM2.5) and ozone (O3) by sex and age in 2005–2016 in metropolitans of Taiwan. MethodsThe distributed lag non-linear model was applied to analyze roles of extreme high (99th percentile) and low (5th percentile) temperatures, and 90th percentile PM2.5 and ozone (O3) in association with CKD risks of deaths, emergency room visits (ERVs), and outpatient visits by age (40–64 and 65 years and above) and sex. Pooled relative risk (RR) and 95% confidence intervals (CI) for all studied areas were estimated using random-effects meta-analysis. ResultsCold spells (<14 °C) showed a higher risk on mortality from CKD for the elderly. Middle-aged population was more vulnerable to high temperature (31.3 °C) with the highest risk for women admitted to outpatient visits [RR = 1.25; (95% CI; 1.17–1.34)]. Women aged 65 years and above had the highest risk after exposing to higher levels of PM2.5 (55 μg/m3) [RR = 1.07; (95% CI; 1.03–1.12)] and O3 (43 ppb) [RR = 1.07; (95% CI; 1.00–1.15)]. ConclusionsThe elderly CKD patients were more prone to the adverse effect of low temperature and high levels of PM2.5 and O3. Middle aged groups were more prone to health risks related to the high temperature. Men are more susceptible to the high temperature, meanwhile women are sensitive to higher levels of PM2.5 and O3.