Relationships between Extreme Heat, Environmental Factors Related to Extreme Heat and Admission Rates of Acute Kidney Injury in the High Temperature Provinces of Thailand

Abstract

          It is well known that extreme heat affects human health. Although it has been found to increase renal morbidity, there are few studies on renal outcome. The aim of this study was to investigate the relationship between extreme heat, environmental factors related to extreme heat, and admission rates of acute kidney injury in the high temperature provinces of Thailand. This study collected in a crosssectional study included 21,090 patients who admitted to the provincial hospital in Kanchanaburi, Nakhon Sawan and Uttaradit provinces with acute kidney injury (ICD10; N17), by collecting data from medical records and the daily data of weather conditions such as temperature, relative humidity and wind speed over the 4-year period (Year 2015-2018) gathered from Thai Meteorological Department. This data were analyzed using descriptive statistics, Generalized Estimating Equations and Negative Binomial Regression
          The study demonstrated high admission rates of acute kidney injury in both summer and winter. The extreme heat effects on acute kidney injury admission were statistically significant. For each 1 ◦C increase in maximum temperature was associated with an increasing acute kidney injury admission (IRR1.06, 95%CI: 1.030-1.097) and a 1 km/h increase in wind speed was associated with a decreasing acute kidney injury admission (IRR0.92, 95%CI: 0.879-0.959). Therefore, monitoring the impact on kidney during hot weather is very important. These findings may have implications for developing intervention strategies such as avoid the heat, drink plenty of fluids, and stay in good air movement in order to decrease admission rates of acute kidney injury especially in Risk-prone areas of Thailand.