Effects of Climate Change on Kidney and Renal Diseases

Kidney/renal illnesses: types, symptoms, and at-risk groups.

Acute kidney injury (AKI) is defined as a rapid (hours to days) decrease in kidney function. AKI represents a wide range of pathophysiological responses of varying severity and causes, including:

Ø Decreasing glomerular filtration rate (GFR).

Ø Increasing concentrations of products of nitrogen metabolism (creatinine, urea).

Ø Manifest with decreased urine output.

AKI is most commonly caused by ischemia or sepsis, or less commonly by obstruction of the ureters, bladder outlet, or urethra.

Kidney stone disease (KSD): caused by hard deposits made of minerals and salts that form inside the kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.

Urinary tract infection (UTI): is a pathogenic bacterial infection in any part of the urinary system, including the kidneys, ureters, bladder and urethra. Permanent kidney damage from a kidney infection can occur due to an untreated UTI. Sepsis is a risk especially if the infection travels up the urinary tract to the kidneys.

Chronic kidney disease (CKD): Defined by abnormalities of kidney structure where the function glomerular filtration rate (GFR) decreases to <60 mL/min/1.73 m² and the presence of kidney damage persists for at least three months. Leading causes: diabetes or hypertension. Associated with the risk of end-stage renal disease, cardiovascular disease, and premature death.

At-risk groups

Elderly people are an at-risk group for all types of kidney/renal diseases, as are pre-existing conditions such as: diabetes, high blood pressure, established heart

problems (heart failure or heart attack) or stroke, family history of kidney disease or kidney failure, obesity with a body mass index (BMI) 30 or higher, smoking, or a

history of acute kidney injury.

Ø AKI: Greater risk on exposure to high temperature, particularly in conjunction with high humidity and for those with pre-existing diabetes or hypertension conditions.

Ø KSD: People who are dehydrated and exposed to heat stress. Combined with extreme heat, high relative humidity is a risk factor. Patients living in low human development index areas are more prone to develop KSI.

Ø UTI: Exposure to high ambient temperatures increases the risk of UTI.

Ø CKD: High ambient temperatures. Pre-existing diabetes or hypertension. Development of CKD may result from repeated AKI driven by subclinical or clinical heatstroke.