BACKGROUND A large proportion of global population uses solid fuels for household purposes, and limited evidence from previous studies suggests that it might be associated with reduced renal function. OBJECTIVES To investigate the association between household use of different types of fuels and kidney disease-related mortality. METHODS We analyzed data from the Golestan Cohort Study, a population-based prospective cohort study conducted in northeastern Iran, with 50,045 individuals aged 40-75 years enrolled in the period 2004-2008 and followed through April 2023. Information on household fuel use was collected using validated questionnaires. We estimated adjusted hazards ratios (HRs) and corresponding 95% confidence intervals (CIs) using Cox proportional hazards models with age as the time scale. The outcome of interest was death due to any kidney disease, excluding kidney cancer (ICD-10 codes: N00-N19, N25-N29). RESULTS During 724,063.62 person-years of follow-up, 262 participants died due to kidney disease. The risk of kidney disease-related mortality was higher with longer duration of biomass use for cooking or house heating (HR for every 10-year increase: 1.20; 95% CI: 1.04-1.37), while it was not associated with longer duration of using kerosene (10-y HR: 1.09; 95% CI: 0.95-1.24), or gas (10-y HR: 1.00; 95% CI: 0.86-1.16). Estimates for lifetime duration of fuel burning for both cooking and house heating (exclusive fuel use) did not differ according to whether used heating stoves were chimney-equipped or not for kerosene, while they differed for biomass (10-y HR, chimney-equipped: 1.06 [95% CI: 0.95-1.18]; 10-y HR, not chimney-equipped: 1.19 [95% CI: 1.06-1.34]; Pdifference=0.025). DISCUSSION The findings of our study suggest that burning biomass for household purposes with poor ventilation is associated with kidney disease-related mortality. Interventions fostering the adoption of chimney-equipped stoves should be considered to reduce mortality due to use of solid fuels. https://doi.org/10.1289/EHP15629.

中文翻译：

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家庭燃料使用和肾脏疾病相关死亡率：Golestan 队列研究。

背景 全球很大一部分人口将固体燃料用于家庭用途，先前研究的有限证据表明它可能与肾功能下降有关。目的 探讨家庭使用不同类型燃料与肾脏疾病相关死亡率之间的关联。方法 我们分析了 Golestan 队列研究的数据，这是一项在伊朗东北部进行的基于人群的前瞻性队列研究，在 2004-2008 年期间招募了 50,045 名年龄在 40-75 岁之间的个体，并随访至 2023 年 4 月。使用经过验证的问卷收集有关家庭燃料使用的信息。我们使用以年龄为时间尺度的 Cox 比例风险模型估计了调整后的风险比 （HRs） 和相应的 95% 置信区间 （CIs）。感兴趣的结局是任何肾脏疾病导致的死亡，不包括肾癌（ICD-10 代码：N00-N19、N25-N29）。结果 在 724,063.62 人年的随访中，262 名参与者死于肾脏疾病。 使用生物质做饭或家庭取暖的时间越长，肾脏疾病相关死亡的风险就越高（每 10 年增加的 HR：1.20;95% CI：1.04-1.37），而它与使用煤油（10 年 HR：1.09;95% CI：0.95-1.24）或燃气（10 年 HR：1.00;95% CI：0.86-1.16）的时间延长无关。根据用过的加热炉是否配备烟囱（不含燃料使用），对烹饪和家庭供暖（不包括燃料使用）的燃料燃烧寿命的估计没有差异，而生物质则不同（10 年 HR，配备烟囱：1.06 [95% CI：0.95-1.18];10 年 HR，未配备烟囱：1.19 [95% CI：1.06-1.34];Pdifference=0.025）。讨论我们的研究结果表明，在通风不良的情况下，为家庭目的燃烧生物质与肾脏疾病相关的死亡率有关。应考虑采取促进采用烟囱式炉灶的干预措施，以降低因使用固体燃料而造成的死亡率。https://doi.org/10.1289/EHP15629。