Climate Change and the Kidney

Ann Nutr Metab. 2019;74 Suppl 3:38-44. doi: 10.1159/000500344. Epub 2019 Jun 14.

Abstract

The worldwide increase in temperature has resulted in a marked increase in heat waves (heat extremes) that carries a markedly increased risk for morbidity and mortality. The kidney has a unique role not only in protecting the host from heat and dehydration but also is an important site of heat-associated disease. Here we review the potential impact of global warming and heat extremes on kidney diseases. High temperatures can result in increased core temperatures, dehydration, and blood hyperosmolality. Heatstroke (both clinical and subclinical whole-body hyperthermia) may have a major role in causing both acute kidney disease, leading to increased risk of acute kidney injury from rhabdomyolysis, or heat-induced inflammatory injury to the kidney. Recurrent heat and dehydration can result in chronic kidney disease (CKD) in animals and theoretically plays a role in epidemics of CKD developing in hot regions of the world where workers are exposed to extreme heat. Heat stress and dehydration also has a role in kidney stone formation, and poor hydration habits may increase the risk for recurrent urinary tract infections. The resultant social and economic consequences include disability and loss of productivity and employment. Given the rise in world temperatures, there is a major need to better understand how heat stress can induce kidney disease, how best to provide adequate hydration, and ways to reduce the negative effects of chronic heat exposure.

Keywords: Global warming; Heat waves; Heatstroke; Kidney stones; Mesoamerican nephropathy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Climate Change
  • Dehydration
  • Heat Stress Disorders / epidemiology*
  • Heat Stress Disorders / etiology
  • Hot Temperature
  • Humans
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / etiology