title: Environmental NO2 and CO Exposure: Ignored Factors Associated with Uremic Pruritus in Patients Undergoing Hemodialysis.
abstract: Uremic pruritus (UP), also known as chronic kidney disease-associated pruritus, is a common and disabling symptom in patients undergoing maintenance hemodialysis (MHD). The pathogenesis of UP is multifactorial and poorly understood. Outdoor air pollution has well-known effects on the health of patients with allergic diseases through an inflammatory process. Air pollution-induced inflammation could occur in the skin and aggravate skin symptoms such as pruritus or impair epidermal barrier function. To assess the role of air pollutants, and other clinical variables on uremic pruritus (UP) in HD patients, we recruited 866 patients on maintenance HD. We analyzed the following variables for association with UP: average previous 12-month and 24-month background concentrations for nitrogen dioxide (NO2) and carbon monoxide (CO), and suspended particulate matter of <2.5 μm (PM2.5). In a multivariate logistic regression, hemodialysis duration, serum ferritin levels, low-density lipoprotein levels, and environmental NO2/CO levels were positively associated with UP, and serum albumin levels were negatively associated with UP. This cross-sectional study showed that air pollutants such as NO2 and CO might be associated with UP in patients with MHD.
authors: Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan, ROC.|Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors: Wen-Hung
authors: WH
authors: Huang
authors: Division of Nephrology, Department of Internal Medicine, Tao-Yuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan, ROC.|Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, ROC.
authors: Jui-Hsiang
authors: JH
authors: Lin
authors: Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan, ROC.|Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors: Cheng-Hao
authors: CH
authors: Weng
authors: Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan, ROC.|Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors: Ching-Wei
authors: CW
authors: Hsu
authors: Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan, ROC.|Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors: Tzung-Hai
authors: TH
authors: Yen
mesh_terms: D000368:Aged; D002245:Carbon Dioxide / Q000008:administration & dosage*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000008:administration & dosage*; D011537:Pruritus / Q000209:etiology*; D006435:Renal Dialysis; D014511:Uremia / Q000150:complications / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide; D009585:Nitrogen Dioxide