Abstract: SA-PO1129
Association Between Ambient Temperature and Incident CKD Among US Veterans with Normal Baseline Kidney Function
Session Information
- CKD: Progression, Drugs, Modalities, and Environmental Factors
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Naser, Abu Mohd, The University of Memphis, Memphis, Tennessee, United States
- Naim, Mohammad Abdullah Al Zubair, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Jia, Chunrong, The University of Memphis, Memphis, Tennessee, United States
- Mou, Xichen, The University of Memphis, Memphis, Tennessee, United States
- Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
Background
Ambient temperature may influence chronic kidney disease (CKD) risk, but potential nonlinear associations remain understudied, and the temperature associated with the lowest risk of CKD is unclear.
Methods
We analyzed the association of ambient temperature with incident CKD in 1,500,240 person-visits from 63,116 US Veterans with normal baseline eGFR and UACR, enrolled between 2004–2006 and followed through 2012. Incident CKD was defined as eGFR <60 mL/min/1.73 m2 per KDIGO criteria. Ambient temperature exposures included ZIP code level 1- and 3-day lags, and 7-, 15-, and 30-day moving averages, before each eGFR. We fit mixed-effects logistic models with participant-level random intercepts and cluster-robust standard errors, using 5-knot restricted cubic splines for temperature. Models adjusted for demographics, comorbidities, ZIP code-level socioeconomic status, dew point, and time trend. Non-linearity was assessed using Wald tests of spline terms.
Results
The mean (SD) age was 65.1 (10.7) years; 97.6% of participants were male, and 14.8% were Black. During follow-up, 18,315 participants developed incident CKD (29.0%, 95% CI: 28.7 to 29.4%). Lag 1 temperature exposure showed a V-shaped association with CKD risk (Figure 1, p < 0.001 for nonlinearity), with the lowest odds at approximately 14 °C. Similar patterns were seen for the 3-day lag, while non-linearity diminished for the 7- and 15-day averages and was minimal at 30-day average.
Conclusion
The association between ambient temperature and incident chronic kidney disease (CKD) is nonlinear, with an elevated risk observed at cold and hot extremes. Further studies are needed to determine if avoidance of extreme temperatures could be renoprotective.
Figure 1: 1-day LagTemperature and CKD association
Funding
- Other NIH Support