Air Pollution and Haemodialysis Outcomes

AIR POLLUTION may significantly influence hospital admission and mortality risk among patients receiving haemodialysis, according to a retrospective study examining environmental exposures in end stage kidney disease.

Air Pollution Linked to Adverse Outcomes

Environmental factors are increasingly recognised as important determinants of health, particularly in vulnerable populations. Researchers investigated the relationship between meteorological conditions, air pollution, and clinical outcomes in patients with end stage kidney disease receiving haemodialysis. The analysis included 336 patients treated between 2016–2024 at a hospital in Madrid, Spain. Across the study period, there were 563 hospital admissions and 90 deaths.

The investigators assessed both acute environmental exposure peaks and longer-term exposure using weekly and monthly averages. Separate time-to-event analyses were conducted for mortality and hospital admissions. Multiple statistical approaches were used, including Cox proportional hazards models and parametric survival models for mortality, alongside recurrent-event models for hospital admissions.

Sulphur Dioxide Shows Consistent Association

Among the environmental factors evaluated, sulphur dioxide emerged as the most consistent predictor of adverse outcomes. The pollutant was associated with an increased risk of both mortality and hospital admission across models assessing acute exposure and cumulative exposure. These findings suggest that sulphur dioxide may have both immediate and longer-term effects on clinical outcomes in patients receiving haemodialysis.

Nitrogen dioxide was also associated with mortality, although this relationship was observed only in long-term analyses. According to the authors, this pattern may indicate a cumulative effect of prolonged exposure rather than an impact driven by short term fluctuations.

Weather Factors Influence Clinical Risk

The study also identified associations between meteorological variables and patient outcomes. Solar radiation was linked to accelerated mortality in non-linear survival models, while atmospheric pressure appeared to have a protective association with hospital admissions.

Taken together, the findings highlight the potential impact of air pollution and weather-related exposures on patients with end stage kidney disease who require haemodialysis. The authors suggest that environmental indicators could be incorporated into clinical risk prediction models and public health strategies. Such approaches may help identify periods of elevated risk and support more tailored management for patients receiving haemodialysis, particularly in settings where exposure to air pollutants is common.

The data add to growing evidence that environmental conditions may play an important role in shaping outcomes among individuals with advanced kidney disease and underline the need for further consideration of these factors in patient care planning.

Reference

Santamera-Lastras M et al. Influence of weather and air quality on clinical outcomes in end-stage kidney disease: a retrospective hospital-based study. Environ Health Insights. 2026;DOI:10.1177/11786302261451620.

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