Methylprotodioscin

27365535

The effect of air pollution on the changing pattern of glomerulopathy has not been studied. We estimated the profile of and temporal change in glomerular diseases in an 11-year renal biopsy series including 71,151 native biopsies at 938 hospitals spanning 282 cities in China from 2004 to 2014, and examined the association of long-term exposure to fine particulate matter of <2.5 μm (PM2.5) with glomerulopathy. After age and region standardization, we identified IgA nephropathy as the leading type of glomerulopathy, with a frequency of 28.1%, followed by membranous nephropathy (MN), with a frequency of 23.4%. Notably, the adjusted odds for MN increased 13% annually over the 11-year study period, whereas the proportions of other major glomerulopathies remained stable. During the study period, 3-year average PM2.5 exposure varied among the 282 cities, ranging from 6 to 114 μg/m3 (mean, 52.6 μg/m3). Each 10 μg/m3 increase in PM2.5 concentration associated with 14% higher odds for MN (odds ratio, 1.14; 95% confidence interval, 1.10 to 1.18) in regions with PM2.5 concentration >70 μg/m3. We also found that higher 3-year average air quality index was associated with increased risk of MN. In conclusion, in this large renal biopsy series, the frequency of MN increased over the study period, and long-term exposure to high levels of PM2.5 was associated with an increased risk of MN.

renal biopsy, membranous nephropathy, air pollution

Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China

Xin Xu,* Guobao Wang,* Nan Chen,† Tao Lu,* Sheng Nie,* Gang Xu,‡ Ping Zhang,§ Yang Luo,‖ Yongping Wang,* Xiaobin Wang,¶ Joel Schwartz,** Jian Geng,corresponding author††‡‡ and Fan Fan Houcorresponding author*

2016 Jun 30

23331464

Objectives
• To quantify the impact of androgen deprivation therapy (ADT) in men with a high baseline risk of skeletal complications and evaluate the risk of mortality after a fracture.

Patients and methods
• We studied 75 994 men, aged ≥ 66 years, with localized prostate cancer from the Surveillance, Epidemiology and End Results-Medicare linked data.

• Cox proportional hazard models were employed to evaluate the risk.

Results
• Men with a high baseline risk of skeletal complications have a higher probability of receiving ADT than those with a low risk (52.1% vs 38.2%, P < 0.001). • During the 12-year follow-up, more than 58% of men with a high risk and 38% of men with a low risk developed at least one fracture after ADT. • The dose effect of ADT is stronger among men who received ADT only compared to those who received ADT with other treatments. • In the high-risk group, the fracture rate increased by 19.9 per 1000 person-years (from 52.9 to 73.0 person-years) for men who did not receive ADT compared to those who received 18 or more doses of gonadotropin-releasing hormone agonist among men who received ADT only, and by 14.2 per 1000 person-years (from 45.2 to 59.4 person-years) among men who received ADT and other treatments. • Men experiencing a fracture had a 1.38-fold higher overall mortality risk than those who did not (95% CI, 1.34-1.43). Conclusions • Men with a high baseline risk of skeletal complications developed more fractures after ADT. • The mortality risk is 40% higher after experiencing a fracture. • Consideration of patient risk before prescribing ADT for long-term use may reduce both fracture risk and fracture-associated mortality.

ADT, baseline risk, fracture, prostate cancer

Fracture after androgen deprivation therapy among men with a high baseline risk of skeletal complications

Yu-Hsuan Shao,*† Dirk F. Moore,*‡ Weichung Shih,*‡ Yong Lin,*‡ Thomas L. Jang,* and Grace L. Lu-Yao*†

2014 May 1