Dose-response relationship between arsenic exposure from drinking water and chronic kidney disease in low-to-moderate exposed area in taiwan—a 14-year perspective study

The association of arsenic exposure with Chronic Kidney Disease (CKD) has never been reported in low-to-moderate exposed area in Taiwan. The aim of this study is to examine the dose-response relationship between ingested arsenic and CKD in northeastern Taiwan where well arsenic ranged from undetectable to 3590 μg/L. A total of 6,153 participants were followed 1998–2011. The disease status was ascertained through linkage with National Health Insurance database. Cox regression analysis was used to determine the hazard ratio of the disease associated with arsenic exposure. The dose-response relationship between two arsenic exposure indices and CKD was observed. Hazard ratio was 1.00, 0.92 (95% confidence interval (CI), 0.66–1.28), 1.20 (95%CI, 0.90–1.60), 1.46 (95%CI,1.09–1.95), 1.08 (95%CI,0.80– 1.49) and 1.58 (95%CI,1.14–2.18) in relation to well water arsenic concentration of <10.0, 10.0–24.9, 25.0–49.9, 50.0–99.9, 100.0–499.9 and ≥ 500.0 μg/L (P_trend:0.0099). Significantly increased CKD risk was observed among people consuming contaminated water with arsenic concentration >50 μg/L.