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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Chronic kidney disease (CKD) of unknown origin, possibly related to heat stress, has been reported among agricultural workers in tropical low- and middle-income countries. While high-income countries have greater heat-adaptation capacity, evidence on CKD risks from heat exposure in warm high-income settings is limited. Moreover, the effects of prolonged exposure to non-optimal cold or heat on kidney health remain unclear. This study investigates the associations between long-term non-optimal work-hour temperature exposure and the risks of dialysis progression and mortality in advanced CKD patients in a warm high-income country (HIC).
We conducted a nationwide retrospective cohort study to examine associations between long-term exposure to non-optimal work-hour temperatures and risks of dialysis progression and mortality among patients with advanced CKD in Taiwan, a subtropical-tropical HIC. Data from 86,928 advanced CKD patients enrolled between 2008 and 2021 were analyzed, with follow-up through December 31, 2022. Non-optimal temperature days were defined as mean work-hour temperatures ≥30 °C (hot) or ≤15 °C (cold). Time-weighted percentages and mean temperatures for hot and cold days during follow-up were calculated for each patient. Cox proportional hazards models estimated hazard ratios (HRs) for dialysis progression and mortality per 1% increase in exposure to non-optimal temperature days. Kaplan–Meier curves assessed outcome differences across exposure quartiles, and restricted cubic spline analyses evaluated dose–response relationships.
Each 1% increase in time-weighted cold-day (≤15 °C) exposure was associated with a 14% (HR = 1.14; 95% CI: 1.13–1.14) higher risk of dialysis progression and a 9% (HR = 1.09; 95% CI: 1.09–1.10) higher risk of mortality. Conversely, a 1% increase in hot-day (≥30 °C) exposure was associated with 5% (HR = 0.95; 95% CI: 0.95–0.96) and 3% (HR = 0.97; 95% CI: 0.97–0.98) lower risks of dialysis progression and mortality, respectively. Quartile analyses of time-weighted cold- and hot-day exposure demonstrated a trend of increasing risks of both outcomes with higher cold exposure, whereas higher hot exposure was associated with reduced risks (All P for trend < 0.001). Restricted cubic spline analyses revealed a dose-dependent protective effect of higher mean temperatures (P for linearity or non-linearity < 0.001).
Long-term cold exposure increases dialysis and mortality risks in advanced CKD, whereas prolonged hot exposure may be protective for both outcomes, reflecting population-level heat adaptation in HIC settings. These findings highlight the need for sociodemographic- and climate-sensitive policies to mitigate the adverse health impacts of non-optimal temperatures, particularly among vulnerable groups such as patients with advanced CKD.
