title: Association between Blood Dioxin Level and Chronic Kidney Disease in an Endemic Area of Exposure.
abstract: BACKGROUND
  Dioxin is an industrial pollutant related to various diseases, but epidemiological data on its effects on the kidney are limited. Therefore, we conducted a study to evaluate the association between dioxin exposure and chronic kidney disease (CKD) and identify the related factors.
  
  
  METHODS
  We conducted a community-based cross-sectional study and recruited participants from an area where the residents were exposed to dioxin released from a factory. We defined a "high dioxin level" as polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) ≥ 20 pg WHO98-TEQDF/g lipid in the serum and defined CKD as having an estimated glomerular filtration rate (e-GFR) ≤ 60 mL/min/1.73m2 or a diagnosis of CKD by a physician. The renal function was assessed between 2005 and 2010, and we excluded those who had had kidney diseases before the study started. Comparisons between patients of CKD and those who did not have CKD were made to identify the risk factors for CKD.
  
  
  RESULTS
  Of the 2898 participants, 1427 had high dioxin levels, and 156 had CKD. In the univariate analyses, CKD was associated with high dioxin levels, age, gender, metabolic syndrome, diabetes mellitus, hypertension, and high insulin and uric acid levels. After adjusting for other factors, we found high dioxin levels (adjusted odds ratio [AOR] = 1.76, 95% confidence interval [CI]: 1.04-2.99), female gender (AOR = 1.74, 95%CI: 1.20-2.53), hypertension (AOR = 1.68, 95%CI: 1.17-2.42), high insulin levels (AOR = 2.14, 95% CI: 1.26-3.61), high uric acid levels (AOR = 4.25, 95% CI: 2.92-6.20), and older age (AOR = 4.66, 95% CI: 1.87-11.62 for 40-64 year and AOR = 26.66, 95% CI: 10.51-67.62 for age ≥ 65 year) were independent predictors of CKD.
  
  
  CONCLUSIONS
  A high dioxin level was associated with an increased prevalence of CKD. Therefore, the kidney function of populations with exposure to dioxin should be monitored.
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Tainan Science Park Clinic, Chi-Mei Medical Center, Tainan, Taiwan.|Department of Occupational Safety and Health, Chang Jung Christian University, Tainan, Taiwan.
authors.forename: Chien-Yuan
authors.initials: CY
authors.lastname: Huang
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.|Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Cheng-Long
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jin-Shang
authors.initials: JS
authors.lastname: Wu
authors.affiliation: Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jung-Wei
authors.initials: JW
authors.lastname: Chang
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ya-Yun
authors.initials: YY
authors.lastname: Cheng
authors.affiliation: Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.|Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yau-Chang
authors.initials: YC
authors.lastname: Kuo
authors.affiliation: Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Research Center for Environmental Trace Toxic Substances, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.|Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Research Center for Environmental Trace Toxic Substances, National Cheng Kung University, Tainan, Taiwan.|Occupational Safety, Health, and Medicine Research Center, National Cheng Kung University, Tainan, Taiwan.
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004147:Dioxins / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D004147:Dioxins