空气污染与肾病PPT课件.pptx

空气污染可增加肾脏疾病风险,众所周知，空气污染会导致呼吸系统和心血管疾病，一项最新研究表明，它也有可能导致肾脏损伤。该研究发表在肾脏病顶级杂志JASN上，呼吁关注空气污染对肾脏病发展的作用,JAmSocNephrol.2016Jun30,JAmSocNephrol.2016Jun30,INTRODUCTION,GlomerulardiseaseremainstheleadingcauseofESRDinAsia.Publishedstudieshaveshowngeographicalandracialvariationsinthepatternsofglomerulardiseases.IgAnephropathy(IgAN)isthemostcommonprimaryglomerulopathyinAsia,Europe,Australia,andsomeregionsoftheUnitedStates.Nopublishedstudieshaveevaluatedtheeffectofenvironmentalfactorsonthechangingpatternofglomerulardiseases.,JAmSocNephrol.2016Jun30,Chinacomprises20%oftheworldpopulation.Withrapiddevelopmentsinitseconomyandurbanization,especiallyduringthepastdecade,airpollutionhasbecomeapublichealthprobleminsomecities.Exposuretoairpollution,especiallyparticulatematterof2.5m(PM2.5),hasbeenassociatedwithincreaseddeathandincidenceofcardiovascularevents.,JAmSocNephrol.2016Jun30,Inthisstudy,weanalyzeddatafroman11-yearrenalbiopsyseriesincluding71,151patientsfrom938hospitalsin282citiesacrossChina,encompassingallagegroupsandbothtertiaryandcommunityhospitals,toevaluatesecularpatternofglomerulardiseases.Wefurtherexaminedtheassociationbetweenlong-termexposuretoPM2.5andspecifictypesofglomerulardiseases.,JAmSocNephrol.2016Jun30,JAmSocNephrol.2016Jun30,RESULTS,JAmSocNephrol.2016Jun30,JAmSocNephrol.2016Jun30,JAmSocNephrol.2016Jun30,JAmSocNephrol.2016Jun30,FrequencyofMNvariedgreatlyamonggeographicalregions(Figure2A).Inourstudy,thefrequencyofMNwashigherinthenorthernregion,especiallyinHebeiprovince,themostpollutedareainChina(Figure2B).TheaverageannualincreaseinPM2.5concentration(PM2.5slope)was0.85g/m3peryear,withthehighestincrease(3.2g/m3peryear)observedinthecitiesinHebeiprovince.,JAmSocNephrol.2016Jun30,DISCUSSION,ThisisthefirstandthelargeststudyofanationwidebiopsyseriestoexaminetheeffectofairpollutiononthechangingpatternofglomerulardiseasesinChina.WefoundaremarkableriseintheproportionofMNoveraperiodof11yearsfrom2004to2014.,JAmSocNephrol.2016Jun30,From2004to2014,theadjustedfrequencyofMNincreasedfrom12.2%to24.9%inthisChinesepopulation.TheriskforMNincreased13%annuallyinaregressionanalysis.Projectedfromthistrend,MNwouldsoonpassIgANtobecometheleadingtypeofnephropathyinChina.,JAmSocNephrol.2016Jun30,Each10g/m3increaseinPM2.5concentrationassociatedwith14%higheroddsforMN(oddsratio,1.14;95%confidenceinterval,1.10to1.18)inregionswithPM2.5concentration70g/m3.,JAmSocNephrol.2016Jun30,MNwasalsoreportedinIndia,acountrywithahighlevelofenvironmentalexposures.Incomparison,MNwasshowntobedeclininginotherEastAsiancountrieswithlowexposurelevels,suchasJapanandKorea.,JAmSocNephrol.2016Jun30,Themechanismbywhichlong-termexposuretofineparticulateairpollutionmayincreasetheriskofMNremainstobeelucidated.MNhasbeenrecognizedasanautoimmunediseasecharacterizedbytheformationofcirculatingautoantibodiesandsubepithelialimmunecomplexdepositsinthekidney.,JAmSocNephrol.2016Jun30,Animalstudieshaveshownthatexposuretofineparticulatepromotestheproductionofautoantibodiesandimmunecomplexes.Ai