Associations of cold exposure with hospital admission and mortality due to acute kidney injury: A nationwide time-series study in Korea

Kyoung Nam Kim*, Moon Kyung Shin, Youn Hee Lim, Sanghyuk Bae, Jong Hun Kim, Seung Sik Hwang, Mi Ji Kim, Jongmin Oh, Hyungryul Lim, Jonghyuk Choi, Ho Jang Kwon

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

9 Citationer (Scopus)

Abstract

Background
Emerging evidence supports an association between heat exposure and acute kidney injury (AKI). However, there is a paucity of studies on the association between cold exposure and AKI.

Objective
We aimed to investigate the associations of cold exposure with hospital admission and mortality due to AKI and to explore whether these associations were influenced by age and sex.

Methods
Information on daily counts of hospital admission and mortality due to AKI in 16 regions of Korea during the cold seasons (2010–2019) was obtained from the National Health Insurance Service (a single national insurer providing universal health coverage) and Statistics Korea. Daily mean temperature and relative humidity were calculated from hourly data obtained from 94 monitoring systems operated by the Korean Meteorological Administration. Associations of low temperatures (<10th percentile of daily mean temperature) and cold spells (≥2 consecutive days with <5th percentile of daily mean temperature) up to 21 days with AKI were estimated using quasi-Poisson regression models adjusted for potential confounders (e.g., relative humidity and air pollutants) with distributed lag models and univariate meta-regression models.

Results
Low temperatures were associated with hospital admission due to AKI [relative risk (RR) = 1.12, 95 % confidence interval (CI): 1.09, 1.16]. Cold spells were associated with hospital admission (RR = 1.87, 95 % CI: 1.46, 2.39) and mortality due to AKI (RR = 4.84, 95 % CI: 1.30, 17.98). These associations were stronger among individuals aged ≥65 years than among those aged <65 years.

Conclusion
Our results underscore the need for the general population, particularly the elderly, physicians, and other healthcare providers to be more vigilant to cold exposure, given the risk of AKI. Government agencies need to develop specific strategies for the prevention and early detection of cold exposure-related AKI.
OriginalsprogEngelsk
Artikelnummer160960
TidsskriftScience of the Total Environment
Vol/bind863
Antal sider8
ISSN0048-9697
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by the Research Program funded by the Korea Disease Control and Prevention Agency (fund code 2021-12-304 ).

Publisher Copyright:
© 2022 Elsevier B.V.

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