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논문분류	춘계학술대회 초록집
제목	The impact of sunlight exposure on mortality of ESRD patients: a bi-directional case-crossover study in the Korean nation-wide ESRD cohort.
저자	Yong Chul Kim1, Una Yoon3, Soie Kown1, Jung Nam An2, Dong Ki Kim1, Yon Su Kim1, Chun Soo Lim2, Ho Kim3, Jung Pyo Lee2
출판정보	2018; 2018(1):
키워드	sunlight exposure \| mortality \| end stage renal disease \| vitamin D
초록	Objectives: 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. Methods: Among 134,478 dialysis patients in Korean ESRD cohort from 2001 and 2014, 31,291 patients were enrolled in the seven metropolitan cities, and analyzed with bi-directional case-crossover design. We examined the association of short-term sunlight exposure and mortality in ESRD patients. Temperature, humidity and daily concentrations of nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), carbon monoxide (CO) and particles matter (PM10) was adjusted as confounders. Results: The average age of our study population was 65.6 ± 12.26 (mean ± SD) that included sex (male: 59.96%, female: 41.04%), comorbidity (diabetics: 53.58%, hypertension: 40.5%) and kidney dialysis type (hemodialysis: 73.02%, peritoneal dialysis 26.98 %,). During the follow-up years of 4.68 ± 4.37 (mean ± SD), 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 (ORs [95%CI] for overall: 0.99 [0.98-0.99], P=0.042) in a fully adjusted model. Patients with diabetes (ORs [95%CI] for DM: 0.98 [0.97-0.99], P = 0.016) and over than 75 of age (ORs [95%CI] for over than 75: 0.97 [0.96 – 0.99], P= 0.020) had a higher risk of mortality than non-diabetics and age below 75, respectively. Conclusions: These data suggest that sunlight exposure is inversely correlated with all-cause mortality in dialysis patients, especially in high risk patients such as diabetics and older adults.
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