Open AccessThe impact of sunlight exposure on mortality of patients with end stage renal disease
Author(s) -
Una Amelia Yoon,
Yong Chul Kim,
Hyewon Lee,
Soie Kwon,
Jung Nam An,
Yon Su Kim,
Yon Su Kim,
Chun Soo Lim,
Jung Pyo Lee,
Ho Kim
Publication year - 2019
Publication title -
scientific reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.24
H-Index - 213
ISSN - 2045-2322
DOI - 10.1038/s41598-019-38522-w
Subject(s) - medicine , sunlight , population , end stage renal disease , diabetes mellitus , comorbidity , hemodialysis , kidney disease , dialysis , endocrinology , environmental health , physics , astronomy
Recent data suggest that reduced sunlight exposure is associated with increased mortality in the general population. To date, the association between sunlight exposure and mortality in dialysis patients has not been examined. Among 134,478 dialysis patients in the Korean end-stage renal disease (ESRD) cohort from 2001 to 2014, 31,291 patients were enrolled from seven metropolitan cities, and data were analyzed using bi-directional case-crossover design. We examined the association between short-term sunlight exposure and mortality in ESRD patients. We adjusted for temperature, humidity, and daily concentrations of nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), ozone (O 3 ), carbon monoxide (CO), and particle matter (PM 10 ) as confounders. The characteristics of the study population included age (65.6 ± 12.26 (mean ± standard deviation [SD]) years), sex (male, 59.96%; female, 41.04%), comorbidity (diabetes, 53.58%; hypertension, 40.5%), and kidney dialysis type (hemodialysis, 73.02%; peritoneal dialysis, 26.98%). The mean ± SD follow-up time was 4.68 ± 4.37 years. The daily sunlight exposure was significantly decreased in the case group compared with the control group (P = 0.004). Sunlight exposure was associated with all-cause death overall (ORs [95% CI]: 0.99 [0.98–0.99], P = 0.042) in a fully adjusted model. Patients with diabetes (ORs [95% CI]: 0.98 [0.97–0.99], P = 0.016) or aged higher than 75 years (ORs [95% CI]; 0.97 [0.96–0.99], P = 0.020) had higher risks of mortality than patients without diabetes or aged below 75 years, respectively. These findings suggest that sunlight exposure is inversely correlated with all-cause mortality in dialysis patients.