Journal of Peking University(Health Sciences) >
Effect of modification of antihypertensive medications on the association of nitrogen dioxide long-term exposure and chronic kidney disease
Received date: 2022-05-09
Online published: 2022-10-14
Supported by
the National Natural Science Foundation of China(72125009);the PKU-Baidu Fund(2020BD004);the PKU-Baidu Fund(2020BD005)
Objective: To investigate the potential effect of modification of antihypertensive medications on the association of nitrogen dioxide (NO2) long-term exposure and chronic kidney disease (CKD). Methods: Data of the national representative sample of adult population from the China National Survey of Chronic Kidney Disease (2007-2010) were included in the analyses, and exposure data of NO2 were collected and matched. Generalized mixed-effects models were used to analyze the associations between NO2 and CKD, stratified by the presence of hypertension and taking antihypertensive medications. The stratified exposure-response curves of NO2 and CKD were fitted using the natural spine smoothing function. The modifying effects of antihypertensive medications on the association and the exposure-response curve of NO2 and CKD were analyzed. Results: Data of 45 136 participants were included, with an average age of (49.5±15.3) years. The annual average exposure concentration of NO2 was (7.2±6.4) μg/m3. Altogether 6 517 (14.4%) participants were taking antihypertensive medications, and 4 833 (10.7%) participants were identified as having CKD. After adjustment for potential confounders, in the hypertension population not using antihypertensive medications, long-term exposure to NO2 was associated with a significant increase risk of CKD (OR: 1.38, 95%CI: 1.24-1.54, P < 0.001); while in the hypertension population using antihypertensive medications, no significant association between long-term exposure to NO2 and CKD (OR: 0.96, 95%CI: 0.86-1.07, P=0.431) was observed. The exposure-response curve of NO2 and CKD suggested that there was a non-linear trend in the association between NO2 and CKD. The antihypertension medications showed significant modifying effects both on the association and the exposure-response curve of NO2 and CKD (interaction P < 0.001). Conclusion: The association between long-term exposure to NO2 and CKD was modified by antihypertensive medications. Taking antihypertensive medications may mitigate the effect of long-term exposure to NO2 on CKD.
Lin MA , Jing-yi WU , Shuang-cheng LI , Peng-fei LI , Lu-xia ZHANG . Effect of modification of antihypertensive medications on the association of nitrogen dioxide long-term exposure and chronic kidney disease[J]. Journal of Peking University(Health Sciences), 2022 , 54(5) : 1047 -1055 . DOI: 10.19723/j.issn.1671-167X.2022.05.035
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