ArticleKidney research and clinical practice2021
Effects of residential greenness on clinical outcomes of patients with chronic kidney disease: a large-scale observation study.
Article in Kidney research and clinical practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- The Exposome and the Kidney: A Silent Dialogue Shaping Chronic Kidney Disease.Journal of xenobiotics · 2025Review
- Built environment and chronic kidney disease: current state and future directions.Current opinion in nephrology and hypertension · 2025Review
- Association Between Urban Green Space and Acute Exacerbations of COPD in Korea: A Nationwide Study Using the NHIS-NSC Cohort.International journal of chronic obstructive pulmonary disease · 2025Article
- Greenness and kidney? A review of epidemiological studies on the association between green space and kidney disease.Kidney research and clinical practice · 2024Article
- Exploring "Equigenesis" in the Associations Between Green Space and Kidney Health Among Middle-Aged and Older Adults Using Street View Data.Innovation in aging · 2024Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundAs industrialization and urbanization are accelerating, the distribution of green areas is decreasing, particularly in developing countries. Since the 2000s, the effects of surrounding greenness on self-perceived health, including physical and mental health, longevity, and obesity have been reported. However, the effects of surrounding green space on chronic kidney disease are not well understood. Therefore, we investigated the impact of residential greenness on the mortality of chronic kidney disease patients and progression from chronic kidney disease to end-stage renal disease (ESRD).
methodsUsing a large-scale observational study, we recruited chronic kidney disease patients (n = 64,565; mean age, 54.0 years; 49.0% of male) who visited three Korean medical centers between January 2001 and December 2016. We investigated the hazard ratios of clinical outcomes per 0.1-point increment of exposure to greenness using various models.
resultsDuring the mean follow-up of 6.8 ± 4.6 years, 5,512 chronic kidney disease patients developed ESRD (8.5%) and 8,543 died (13.2%). In addition, a 0.1-point increase in greenness reduced all-cause mortality risk in chronic kidney disease and ESRD patients and progression of chronic kidney disease to ESRD in a fully adjusted model. The association between mortality in ESRD patients and the normalized difference vegetation index was negatively correlated in people aged >65 years, who had normal weight, were nonsmokers, and lived in a nonmetropolitan area.
conclusionChronic kidney disease patients who live in areas with higher levels of greenness are at reduced risk of all-cause mortality and progression to ESRD.
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