EFFECTS OF AMBIENT TEMPERATURE ON RENAL DISEASE HOSPITALIZATIONS IN BRAZIL: A NATIONAL CASE-CROSSOVER STUDY

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EFFECTS OF AMBIENT TEMPERATURE ON RENAL DISEASE HOSPITALIZATIONS IN BRAZIL: A NATIONAL CASE-CROSSOVER STUDY

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Co-author 1

Bo Wen bo.wen@monash.edu Monash University School of Public Health and Preventive Medicine Melbourne Australia *

Co-author 2

Rongbin Xu rongbin.xu@monash.edu Monash University School of Public Health and Preventive Medicine Melbourne Australia -

Co-author 3

Yao Wu yao.wu@monash.edu Monash University School of Public Health and Preventive Medicine Melbourne Australia -

Co-author 4

Micheline Coêlho coelhomicheline@gmail.com University of São Paulo/INSPER Faculty of Medicine São Paulo Brazil -

Co-author 5

Paulo Saldiva pepino@usp.br University of São Paulo/INSPER Faculty of Medicine São Paulo Brazil -

Co-author 6

Yuming Guo yuming.guo@monash.edu Monash University School of Public Health and Preventive Medicine Melbourne Australia -

Co-author 7

Shanshan Li shanshan.li@monash.edu Monash University School of Public Health and Preventive Medicine Melbourne Australia -

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Climate change is amplifying the global threat of injuries, illnesses, and mortality. However, the relationship between ambient temperature and renal diseases remains insufficiently understood. This study aims to quantify the risk and the temperature-attributable burden of hospitalizations due to renal diseases.

Methods

We obtained daily hospital admission data from 1,816 Brazilian cities between 2000 and 2015. Using a time-stratified case-crossover approach, we assessed the association between daily mean temperature and renal disease hospitalizations. We estimated relative risks (RRs), attributable fractions (AFs), and corresponding 95% confidence intervals (CIs) to determine the temperature-related risks and burden.

Results

During the study period, 2,726,886 hospital admissions for renal diseases were recorded. Nationally, each 1°C increase in daily mean temperature was associated with a 0.9% rise in hospitalization risk over lag 0–7 days (RR = 1.009, 95% CI: 1.008–1.010). The strongest association appeared at lag 0 days, persisting through lag 1–2 days. Females, children aged 0-4 years, and adults aged 80 years and older showed greater vulnerability. Overall, 7.4% (95% CI: 5.2–9.6%) of renal disease hospitalizations were attributable to elevated temperatures, equivalent to 202,093 (95% CI: 141,554–260,594) cases.

Conclusion

This nationwide analysis provides evidence for strengthening policies aimed at reducing heat-related hospitalizations and addressing the health impacts of climate change.

Kewords