Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
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.
Heat exposure associated with climate change has been implicated in recurrent, asymptomatic acute kidney injury, increasing the risk of CKD progression and mortality. However, the relationship between seasonal variation in estimated glomerular filtration rate (eGFR) and clinical outcomes in routine outpatient care in Japan remains unclear. This study aimed to describe seasonal changes in eGFR and to assess the prognostic impact of summer eGFR decline on renal replacement therapy (RRT) initiation and cardiovascular outcomes in regular outpatient settings.
We conducted a retrospective cohort study of adult outpatients who underwent serum creatinine measurement between 2010 and 2023. Seasons were defined by average temperatures in Kanazawa city, Ishikawa, Japan: spring (March–June), summer (July–August), autumn (September–November), and winter (December–February). Seasonal differences in eGFR were estimated using linear mixed-effects models, with spring as the reference. We defined “a summer eGFR decline” as ≥3.0 mL/min/1.73m² from spring to summer in the same year since this value was close to the upper threshold of the lowest quartile. Associations between summer eGFR decline and subsequent RRT initiation, cardiovascular events, heart failure hospitalization, and all-cause mortality (≥30 days) were analyzed using multivariable time-dependent Cox proportional hazards models with multiple imputation for missing data.
Among 10,773 patients (46% female, mean age 53±20 years, mean eGFR 85.2±29.6 mL/min/1.73m²), eGFR significantly decreased in summer (-1.2 [95% CI -1.3 to -1.1]) and increased in winter (+0.8 [95% CI 0.7 to 0.9]) compared with spring (both p<0.01). The median spring–summer eGFR change was -1.2 (IQR -3.2 to 1.1). Patients with summer eGFR decline were older and more likely to have higher baseline eGFR, hypertension, and diabetes. Summer eGFR decline was associated with increased risks of RRT initiation (HR 4.5 [95% CI 2.9–6.8], p<0.001) and heart failure hospitalization (HR 1.8 [95% CI 1.1–3.1], p=0.02), but not cardiovascular events or mortality (p≥0.06).
In routine outpatient practice, eGFR shows seasonal variation, with summer decline associated with higher risks of RRT initiation and heart failure hospitalization. These findings suggest the potential value of early intervention strategies considering seasonal kidney function changes.
