Environment International (Dec 2024)
Extreme temperature events, “Life’s Essential 8”, and prevalence of chronic kidney disease: A nationally representative surveillance in China
Abstract
The population disease burden caused by extreme temperature events has been increasing. However, research on the long-term effects of extreme temperature events on chronic kidney disease (CKD), as well as the combined effects with individual behaviors and metabolic factors is still lacking. Based on 176,874 participants from the most recent nationally representative surveillance on CKD and validated high spatial resolution (0.1°) remote-sensing products, this study investigated the associations between extreme temperature events in the preceding five years before investigation and CKD (defined by reduced renal function or albuminuria) prevalence. We also investigated the associations between “Life’s Essential 8”, a recognized scale to evaluate overall cardiovascular health (CVH) based on individual behaviors and metabolic indicators and CKD prevalence, as well as its combined effects with extreme temperature events. One additional day of heat waves and cold spells per year was associated with increased ORs of CKD [1.10 (95 % CI: 1.08, 1.11) and 1.07 (95 % CI: 1.05, 1.09), respectively]. Meanwhile, per standard deviation (SD) increment in health behavior score (SD = 16.1), health factor score (SD = 18.4), and overall CVH score (SD = 12.4) were associated with decreased ORs of CKD [0.92 (95 % CI: 0.90, 0.93), 0.60 (95 % CI: 0.59, 0.61), and 0.64 (95 % CI: 0.63, 0.65, respectively]. Relative to higher heat wave & lower CVH score group, the ORs of CKD were 0.87 (95 % CI: 0.84, 0.90), 0.51 (95 % CI: 0.48, 0.53), and 0.42 (95 % CI: 0.40, 0.44) in lower & lower, higher & higher, and lower & higher group, respectively. Our findings underscore the importance of considering the synergistic effects of individual behavioral and metabolic factors for strategies to mitigate the impacts of climate change on CKD.
