Association between Environmental Factors and Kidney Diseases: A Nationwide Population-Based Study

초록

Background:It is well known that various environmental factors including air pollution increase the risk of kidney disease. We aimed to elucidate the risk of chronic kidney disease according to the indoor air quality and urinary volatile organic compounds (VOCs) using data from the Korea National Health and Nutrition Examination Survey (KNHANES).Methods:The ratio of indoor and ambient PM2.5 and urine creatinine-corrected VOCs concentration were extracted from the KNHANES VIII (2019-2021) dataset. CKD was defined as estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73m2, and the association between environmental factors and CKD was analyzed through multiple linear regression model.Results:A total of 1,319 participants was analyzed in this study. The highest quartile of indoor and ambient PM2.5 ratio was associated with increased risk of CKD (odds ratio(OR), 4.28; 95% confidence interval(95% CI), 1.43-12.75) after adjustment of age, sex, comorbidities, and window opening status. The urinary concentration of several VOCs (3,4MHA [3,4-Methylhexanoic Acid], PGA [Phenylglyoxylic Acid], MA [Maleic Acid], DHBMA [Dihydroxybenzene Mercapturic Acid]) have been found to have statistically significant association with reduced kidney function. ([3,4MHA] OR, 5.86; 95% CI, 1.30-26.45; [PGA] OR, 14.30; 95% CI, 1.53-133.78; [MA] OR, 5.38; 95% CI, 1.03-28.12; [DHBMA] OR, 4.14; 95% CI, 0.77-22.21).Conclusion:In this cross-sectional study, the indoor air quality of PM2.5 relative to the concentration of PM2.5 in the ambient air was associated with the deterioration of kidney function and urinary VOCs concentration showed the association with declined kidney function which could be used to be a predictive marker of CKD.