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

Background: Health 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 (O-3) by sex and age in 2005-2016 in metropolitans of Taiwan. Methods: The 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. Results: Cold 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 mu g/m(3)) [RR = 1.07; (95% CI; 1.03-1.12)] and O-3 (43 ppb) [RR = 1.07; (95% CI; 1.00-1.15)]. Conclusions: The elderly CKD patients were more prone to the adverse effect of low temperature and high levels of PM2.5 and O-3. 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 O-3.

Automated summary

A study in metropolitans of Taiwan found that extreme temperature and air pollutants have effects on mortality and morbidity of chronic kidney disease. The elderly are more susceptible to low temperature and high levels of pollutants, while middle-aged individuals are more vulnerable to high temperature. Men are more sensitive to high temperature, while women are sensitive to higher levels of pollutants.