The Associations between Arsenic in Drinking Water and Chronic Kidney Disease

Abstract

Previous governmental surveys have showed that more than half a million residents in Taiwan had drunk water that contained arsenic levels higher than 0 05 ppm particularly those residents in the southern part of Taiwan On the other hand the incidence of end-stage renal disease (ESRD) in Taiwan is among the highest in the world and southern Taiwan also has higher incidence nationwild During its urinary elimination arsenic concentrates in the kidney and affects the function of proximal convoluted tubules and glomerulus However epidemiology studies on the associations between arsenic exposure and chronic kidney disease (CKD) are limited The objectives of the proposed study are to evaluate the associations of arsenic exposure with the risks of CKD and with the development of CKD to ESRD and to identify the genetic markers single nucleotide polymorphisms (SNP) of this process as well as other useful biomarkers We will begin to recruit CKD patients’ fellow-up study at a teaching hospital in southwestern Taiwan and conduct a nationwide cohort study on MJ Health Management Institution in Taiwan from 2000 to 2009 We will also analyze the longitudinal data on 1 000 000 people from 1996 to 2010 which are available from the National Health Insurance Research Database (NHIRD) to evaluate the associations between arsenic level in drinking water and the risks of CKD / ESRD Secondly we will apply geographic information system (GIS) to generate more precise data on arsenic exposure and assess its associations with CKD in greater details We will perform preliminary analysis on the factors that affect the development of CKD to ESRD The proposed project aims to identify the role of arsenic in drinking water in the high incidence of ESRD in southern Taiwan and to provide information on predicting of the susceptibility of development ESRD from CKD The data generated by the proposed project shall help risk stratification of CKD patients and help the planning of individual treatment plans Arsenic levels in drinking water were assessed on the basis of a nationwide census survey conducted by the government of which measurement reports were available for 311 townships Using both 50 μg/L (0 05 mg/L) as the cut-offs we found most of the hot spots were in the southwestern coast and northeastern areas Furthermore we found exposure to arsenic in drinking water was associated with the incidence of CKD / ESRD and the rapid progression of CKD (eGFR decline>5 ml/min/1 73 m2/year) in Taiwan independent of most documented risk factors; the adjusted odds ratio (AOR) is 1 22 95% confidence interval [C I]=1 05-1 42 p

Date of Award	2018 Feb 23
Original language	English
Supervisor	How-Ran Guo (Supervisor)