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Abstract: TH-PO1015

Long-Term Exposure to High Perceived Temperature and Risk for Mortality Among CKD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Ko, Ara, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Lee, Jeonghwan, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, Korea (the Republic of)
Background

Risks for climate change is emerging and interest in health risks from high temperature exposure is growing. The perceived temperature (PT) is an equivalent temperature based on a complete heat budget model of the human body. We aimed to analyze the effect of PT on the overall mortality among chronic kidney disease (CKD) patients.

Methods

A total of 32,870 patients with CKD in Seoul participated in a retrospective cohort (2001-2018) at three medical centers. PT during summer season was calculated using meteorological factors including air temperature nearby automated weather station, dew point temperature, wind velocity, and total cloud amount. We assessed the association of PT using Kriging spatial interpolation on mortality in CKD patients in the time-varying Cox proportional hazard model that was adjusted for sex, age, body mass index, hypertension, diabetes mellitus, estimated glomerular filtration rate, smoking, alcohol consumption, and education level.

Results

During the 6.14 ± 3.96 years of follow-up, 3,863 deaths (13%) were observed. In multivariable analysis, average level of PT (hazard ratio (HR) 1.292, 95% confidenc interval (CI) 1.255-1.331) and maximum level of PT (HR 1.356, 95% CI 1.309-1.404) showed increased risk for overall mortality among CKD patients. The c-index for mortality was high in the order of PT, temperature, discomfort index, and heat index (average level, 0.790, 0.785, 0.785, and 0.784; maximal level, 0.790, 0.784, 0.782, and 0.781). When stratified by age, diabetes mellitus, and estimated glomerular filtration rate, CKD patient with old age (age above 65 years old), without diabetes mellitus, and estimated glomerular filtration rate above 60 ml/min/1.73 m2 showed higher c-index levels. In addition, the risk for death in winter and spring seasons was also proved as significant with HR of 1.152 (95% CI 1.088-1.220) and 1.067 (95% CI 1.014-1.123) compared with the summer and autumn season mortality with according to HR of 1.401 (95% confidence interval 1.313-1.496).

Conclusion

Long-term exposure to high perceived temperature during summer season increase the risk of mortality among CKD patients.