{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:28:27Z","timestamp":1790270907312,"version":"4.1.0"},"reference-count":45,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T00:00:00Z","timestamp":1544745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Air pollution has been associated with autoimmune diseases. Nephrotic syndrome is a clinical manifestation of immune-mediated glomerulopathy. However, the association between nephrotic syndrome and air pollution constituents remains unknown. We conducted this nationwide retrospective study to investigate the association between PM2.5 and nephrotic syndrome. Methods: We used the Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality-Monitoring Database (TAQMD). We combined and stratified the LHID and the TAQMD data by residential areas of insurants linked to nearby air quality-monitoring stations. Air pollutant concentrations were grouped into four levels based on quartile. Univariable and multivariable Cox proportional hazard regression models were applied. Findings: Relative to Q1-level SO2, subjects exposed to the Q4 level were associated with a 2.00-fold higher risk of nephrotic syndrome (adjusted HR = 2.00, 95% CI = 1.66\u20132.41). In NOx, relative to Q1 NOx concentrations, the adjusted HRs of nephrotic syndrome risk were 1.53 (95% CI = 1.23\u20131.91), 1.30 (95% CI = 1.03\u20131.65), and 2.08 (95% CI = 1.69\u20132.56) for Q2, Q3, and Q4 levels, respectively. The results revealed an increasing trend for nephrotic syndrome risk correlating with increasing levels of NO, NO2, and PM2.5 concentrations. Interpretation: High concentrations of PM2.5, NO, NO2, and SO2 are associated with increased risk of nephrotic syndrome.<\/jats:p>","DOI":"10.3390\/ijerph15122860","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T12:11:08Z","timestamp":1544789468000},"page":"2860","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Association of Exposure to Fine-Particulate Air Pollution and Acidic Gases with Incidence of Nephrotic Syndrome"],"prefix":"10.3390","volume":"15","author":[{"given":"Shih-Yi","family":"Lin","sequence":"first","affiliation":[{"name":"Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, 404 Taichung, Taiwan"},{"name":"Division of Nephrology and Kidney Institute, China Medical University Hospital, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu-Huei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, 404 Taichung, Taiwan"},{"name":"Department of Chest Medicine, China Medical University Hospital, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Management Office for Health Data, China Medical University Hospital, 404 Taichung, Taiwan"},{"name":"College of Medicine, China Medical University, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, 404 Taichung, Taiwan"},{"name":"Department of Family Medicine, China Medical University Hospital, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsueh","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, China Medical University Hospital, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Kuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Kidney Institute, China Medical University Hospital, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Y.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, 404 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6368-3676","authenticated-orcid":false,"given":"Chia-Hung","family":"Kao","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, 404 Taichung, Taiwan"},{"name":"Department of Nuclear Medicine and PET Center, China Medical University Hospital, 404 Taichung, Taiwan"},{"name":"Department of Bioinformatics and Medical Engineering, Asia University, 413 Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1053\/j.ajkd.2004.10.019","article-title":"Proteinuria reduction and progression to renal failure in patients with type 2 diabetes mellitus and overt nephropathy","volume":"45","author":"Atkins","year":"2005","journal-title":"Am. 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