Abstract
This study investigates the correlation between short-term exposure to nitrogen dioxide (NO(2)) and hospitalization for chronic kidney disease (CKD) in Lanzhou, China. A distributed lag nonlinear model (DLNM) was employed to examine the relationship between changes in NO(2) concentration and CKD hospitalizations. Subgroup analyses were conducted to assess the sensitivity of different populations to NO(2) exposure. A total of 35,857 CKD hospitalizations occurred from 1 January 2014 to 31 December 2019. The average daily concentration of NO(2) was 47.33 ± 17.27 µg/m(3). A significant exposure response relationship was observed between changes in NO(2) concentration and the relative risk (RR) of CKD hospitalization. At lag0 (the same day) and lag0-1 (cumulative same day and the previous 1 day) to lag0-4 (cumulative same day and the previous 4 days), NO(2) exhibited a harmful effect on CKD hospitalizations, with the maximum effect occurring at lag0-1. For every 10 µg/m(3) increase in NO(2) concentration, the RR of CKD hospitalization was 1.034 [95% confidence interval (CI): 1.017, 1.050]. Subgroup analyses revealed that the adverse effects of NO(2) were more pronounced in females and individuals aged ≥65 years. The harmful effects were also more significant during the cold season. In conclusion, short-term NO(2) exposure is associated with an increased relative risk of CKD hospitalization. Continuous efforts to improve air quality are essential to protect public health.