Digital Healthcare for Airway Diseases from Personal Environmental Exposure

Association Between Decreased Renal Function and Pulmonary Function Decline in Community-dwelling Adults

BACKGROUND/AIM

Emerging evidence suggests that there is a close relationship between the human lung and kidney. This study evaluated whether decreased renal function was associated with accelerated pulmonary function decline in a large-scale community-based cohort.

PATIENTS AND METHODS

A total of 10,028 subjects of the prospective Ansung-Ansan cohort were eligible for the longitudinal analysis of changes in pulmonary function associated with decreased renal function (glomerular filtration rate <60 ml/min/1.73 m2). Logistic regression analysis was performed to evaluate factors associated with decreased baseline renal function, and a linear mixed model compared changes in pulmonary function in participants with and without decreased renal function after propensity score matching (PSM).

RESULTS

At baseline, subjects with and without decreased renal function showed distinct characteristics, and the factors associated with decreased renal function were age, baseline forced vital capacity, hypertension, and white blood cell (WBC) count. A 1:4 PSM of age, sex, body mass index, and smoking status showed that the proportion of those with hypertension and the WBC count differed between the patients with decreased and normal renal function. In the PSM population, those with decreased renal function had a greater decline in forced expiratory volume in the first second (FEV1) than those without (p=0.0402); however, these differences were not found to be evident when hypertension and WBC count were further matched (p=0.0807).

CONCLUSION

The results of our study demonstrated that decreased renal function was not directly associated with the rapid decline in pulmonary function in a community-based general population setting.

Climate Change, Human Health, and Health Informatics: A New View of Connected and Sustainable Digital Health

The connection between human health and climate change has had a scientific basis for many decades. However, little attention has been directed to applying the science of health informatics to this aspect of health and healthcare until recently. This paper briefly reviews examples of recent international work on two fronts: to consider how health informatics can reduce the carbon footprint of healthcare, and to consider how it can integrate new kinds of data for insights into the human health impacts of climate change. Health informatics has two principles of fundamental relevance to this work - connectedness, in other words linking and integrating health data from multiple sources; and sustainability, in other words making healthcare overall more efficient and effective. Deepening its commitment to these principles will position health informatics as a discipline and a profession to support and guide technological advances that respond to the world's climate health challenges.