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Open AccessArticle

Associations between Water Quality Measures and Chronic Kidney Disease Prevalence in Taiwan

1
Department of Computer Science and Engineering, National Taiwan Ocean University, Keelung 202, Taiwan
2
Division of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
3
Department of Communications, Navigation and Control Engineering, National Taiwan Ocean University, Keelung 202, Taiwan
4
Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
5
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
6
Department of Electrical Engineering, National Taiwan Ocean University, Keelung 202, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2018, 15(12), 2726; https://doi.org/10.3390/ijerph15122726
Received: 16 October 2018 / Revised: 26 November 2018 / Accepted: 28 November 2018 / Published: 3 December 2018
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
To determine the relationships between exposure to environmental contaminants in water and chronic kidney disease (CKD), we investigated the associations of 61 water attributes with the prevalence of CKD and End-Stage Renal Disease (ESRD) using data from 2005 to 2011 from all 22 counties and cities in the main island of Taiwan. We acquired patient information from the Taiwan Longitudinal Health Insurance Database to calculate the age-standardized CKD and ESRD prevalence rates and linked the patients’ residences to the water quality monitoring data, which were sampled periodically for a total of over 45,000 observations obtained from the Taiwan Environmental Water Quality Information Database. The association analysis adjusting for gender, age, and annual effects showed that the zinc (Zn), ammonia, chemical oxygen demand (COD), and dissolved oxygen in rivers were weakly correlated with CKD (τ = 0.268/0.250/0.238/−0.267, p = 6.01×10−6/2.52×10−5/6.05×10−5/3.30×10−5, respectively), but none for ESRD. The importances of Zn and COD in rivers were also demonstrated in a CKD regression model. Moreover, an unusually high CKD prevalence was related to arsenic contamination in groundwater. A further prospective cohort study would improve our understanding of what level of environmental water with risky properties could affect the development of CKD. View Full-Text
Keywords: chronic kidney disease; end-stage renal disease; water contaminants; zinc; ammonia; chemical oxygen demand; dissolved oxygen; arsenic chronic kidney disease; end-stage renal disease; water contaminants; zinc; ammonia; chemical oxygen demand; dissolved oxygen; arsenic
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MDPI and ACS Style

Chang, K.Y.; Wu, I.-W.; Huang, B.-R.; Juang, J.-G.; Wu, J.-C.; Chang, S.-W.; Chang, C.C. Associations between Water Quality Measures and Chronic Kidney Disease Prevalence in Taiwan. Int. J. Environ. Res. Public Health 2018, 15, 2726.

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