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논문분류	춘계학술대회 초록집
제목	Long-term particulate matter exposure increases the mortality risk of patients with end-stage renal disease
저자	Jiyun Jung, Jae Yoon Park, Yong Chul Kim, Yon Su Kim, Jung Pyo Lee, Ho Kim
출판정보	2019; 2019(1):
키워드	particulate matter \| mortality \| end stage renal disease
초록	Aerodynamic particulate matter (PM) significantly worsens morbidity and mortality in various diseases, especially in cardiovascular and pulmonary diseases. However, little is known for relationship between PM and mortality of end-stage renal disease (ESRD). 5041 patients who began dialysis from August 2008 to February 2015 were prospectively enrolled in the Clinical Research Center for End-Stage Renal Disease cohort study. We assigned daily mean concentration of PM < 10 μm in aerodynamic diameter (PM10) to each participants for provincial-level divisions (si-do) by the location of station. Time-varying Cox proportional hazard models were used to investigate the relationship between PM10 and mortality of ESRD patients who have received dialysis. Stratified analysis was also conducted by potential confounders such as age, sex, smoking status, education, insurance, marital status, and social and familial support. During the follow-up period (mean 4.18 years), 1475 deaths occurred among 5041 participants. We found non-linear relationship between PM10 and mortality. Based on a threshold level at 44.15μg/m3, although lower PM10 group had higher HRs for mortality with decrease in PM10 (HR 0.71, CI 0.69-0.74), higher PM10 group had higher HRs with increase in PM10 (HR 1.25, CI 1.22-1.28). Those who married and highly educated were at high risk in both groups, but opposite tendency was shown in each groups when stratified by population density, family and social support and the number of hospitals. We found that the mortality of ESRD patients has contrary effects based on a threshold level of PM10. It may be caused by toxicity of PM and characteristics of behavior at the region with relatively low concentration of PM10.
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