Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities  

作　　者：Fu-Lin Wang Wan-Zhou Wang Fei-Fei Zhang Su-Yuan Peng Huai-Yu Wang Rui Chen Jin-Wei Wang Peng-Fei Li Yang Wang Ming-Hui Zhao Chao Yang Lu-Xia Zhang 

机构地区：[1]Institute of Medical Technology,Peking University Health Science Center,Beijing 100191,China [2]National Institute of Health Data Science at Peking University,Beijing 100191,China [3]Department of Occupational and Environmental Health Sciences,School of Public Health,Peking University,Beijing 100191,China [4]Renal Division,Department of Medicine,Peking University First Hospital,Peking University Institute of Nephrology,Beijing 100034,China [5]Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases,Chinese Academy of Medical Sciences,Beijing 100034,China [6]Advanced Institute of Information Technology,Peking University,Hangzhou 311215,China [7]National Climate Center,China Meteorological Administration,Beijing 100081,China [8]Peking-Tsinghua Center for Life Sciences,Beijing 100034,China

出　　处：《Military Medical Research》2024年第4期469-478,共10页军事医学研究（英文版）

基　　金：This study was supported by the National Natural Science Foundation of China(82003529,72125009);the National Key Research and Development Program of the Ministry of Science and Technology of China(2019YFC2005000);the Chinese Scientific and Technical Innovation Project 2030(2018AAA0102100);the National High Level Hospital Clinical Research Funding(“Star of Outlook”Scientific Research Project of Peking University First Hospital,2022XW06);the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-046);the Young Elite Scientists Sponsorship Program by CAST(2022QNRC001);the PKU-Baidu Fund(2020BD004,2020BD005 and 2020BD032).

摘　　要：Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.

关 键 词：Chronic kidney disease HOSPITALIZATION Climate change Temperature Time-series study 

分 类 号：R692[医药卫生—泌尿科学]