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논문분류	춘계학술대회 초록집
제목	Association between long-term exposure to PM2.5 and MACE onset in people with chronic kidney disease
저자	Miju Kim
출판정보	2024; 2024(1):
키워드
초록	Objectives: Although recent studies continue to report the association between long-term exposure to ultrafine dust and the occurrence of CKD, the health impact assessment of ultrafine dust in patients with CKD has limited performance of large-scale data-based related studies. Methods: This study was conducted using a sample cohort of the Health Insurance Corporation consisting of samples representing million of Korean people. By linking the medical history DB and the examination DB (2007-2009), subjects over 40 years of age with CKD during this period (ICD-10: N18) or with 60 or less eGFR (mL/min/1.73m2) were defined as CKD. And this CKD/non-CKD groups were followed up 2010-2019, and the annual average value based on the subject's residence was used for PM2.5 exposure, using a machine-learning ensemble model that predicted the monthly average concentration of all 250 cities, counties, and districts nationwide (excluding Jeju-Island). MACE occurrence was defined as the fastest occurrence of MI (ICD-10:I21-I22), Cerebrovascular disorders (G45-G46, H34,I60-69), or cardiovascular death (ICD-10:I). The association between annual average ultrafine dust and MACE occurrence was estimated using Cox-model with time-varying variables, and the risk of the CKD group was evaluated using the interaction between the annual average air pollution and the CKD group variable. Results: 9,383 CKD-group and 238,738 NON-CKD group were included.(Total:2,262,526) And the number of MACE was 26,097. As a result of the Cox-model, CKD patients had 1.304(95% CI: [1.04, 1.28]) times higher HR per 5μg/m3 increase in annual average ultrafine dust compared to the non-CKD. Conclusions: Using the Health Insurance Corporation sample cohort, this study confirmed that the risk of MACE occurrence due to exposure to ultrafine dust in adults over 40 years of age nationwide was statistically significantly higher in subjects with CKD than subjects without CKD.
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