TY - JOUR

T1 - Associations of cold exposure with hospital admission and mortality due to acute kidney injury

T2 - A nationwide time-series study in Korea

AU - Kim, Kyoung Nam

AU - Shin, Moon Kyung

AU - Lim, Youn Hee

AU - Bae, Sanghyuk

AU - Kim, Jong Hun

AU - Hwang, Seung Sik

AU - Kim, Mi Ji

AU - Oh, Jongmin

AU - Lim, Hyungryul

AU - Choi, Jonghyuk

AU - Kwon, Ho Jang

N1 - Publisher Copyright: © 2022 Elsevier B.V.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - Acute kidney injury

KW - Cold spell

KW - Elderly

KW - Low temperature

KW - Time-series

U2 - 10.1016/j.scitotenv.2022.160960

DO - 10.1016/j.scitotenv.2022.160960

M3 - Journal article

C2 - 36528107

AN - SCOPUS:85144062701

VL - 863

JO - Science of the Total Environment

JF - Science of the Total Environment

SN - 0048-9697

M1 - 160960

ER -