Journal of Preventive Medicine and Public Health

Review

High Temperatures and Kidney Disease Morbidity: A Systematic Review and Meta-analysis: Woo-Seok Lee, Woo-Sung Kim, Youn-Hee Lim, Yun-Chul Hong; J Prev Med Public Health. 2019;52(1):1-13. Published online November 20, 2018; DOI: https://doi.org/10.3961/jpmph.18.149

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Abstract Summary PDF Supplementary Material

Objectives
In recent years, serious concerns have been raised regarding the impacts of rising temperatures on health. The present study was conducted to investigate the relationship between elevated temperatures and kidney disease through a systematic review and meta-analysis.
Methods
In October 2017, 2 researchers independently searched related studies in PubMed and Embase. A meta-analysis was conducted using a random-effects model, including only studies that presented odds ratios, relative risks, or percentage changes, along with 95% confidence intervals (CIs). The characteristics of each study were summarized, and the Egger test and funnel plots were used to evaluate publication bias.
Results
Eleven studies that met the criteria were included in the final analysis. The pooled results suggest an increase of 30% (95% CI, 20 to 40) in kidney disease morbidity with high temperatures. In a disease-specific subgroup analysis, statistically significant results were observed for both renal colic or kidney stones and other renal diseases. In a study design–specific subgroup analysis, statistically significant results were observed in both time-series analyses and studies with other designs. In a temperature measure–specific subgroup analysis, significant results were likewise found for both studies using mean temperature measurements and studies measuring heat waves or heat stress.
Conclusions
Our results indicate that morbidity due to kidney disease increases at high temperatures. We also found significant results in subgroup analyses. However, further time-series analyses are needed to obtain more generalizable evidence.

Summary

Korean summary
최근들어 기온상승에 따른 건강영향과 관련하여 전 세계적으로 심각한 우려가 제기되고 있으며, 저자들은 이에 착안하여 본 연구에서 체계적 문헌고찰과 메타분석을 통해 기온상승과 신장질환 발생간의 연관성을 연구하고자 하였다. 연구결과에서는 임계온도 이상으로 기온이 상승하면 참고치에 비해 신장질환으로의 이환율이 30% (95% 신뢰구간, 20% 에서 40%) 증가함을 보였고, 부집단 분석에서도 역시 유의한 결과를 나타내었다. 그러나 보다 일반화 가능한 근거를 얻기 위해서는 기온상승과 신장질환 발생에 관한 더 많은 시계열 분석 연구가 필요할 것으로 사료된다.

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Original Article

Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study: Chinakorn Sujimongkol, Cholatip Pongskul, Supannee Promthet; J Prev Med Public Health. 2018;51(4):205-212. Published online June 19, 2018; DOI: https://doi.org/10.3961/jpmph.18.066

4,714 View
136 Download
1 Crossref

Abstract PDF

Objectives
The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution.
Methods
A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders.
Results
Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome.
Conclusions
Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

Summary

Citations

Citations to this article as recorded by

Associations of Glucometabolic Indices with Aortic Stiffness in Patients Undergoing Peritoneal Dialysis with and without Diabetes Mellitus
Chi-Chong Tang, Jen-Pi Tsai, Yi-Hsin Chen, Szu-Chun Hung, Yu-Li Lin, Bang-Gee Hsu
International Journal of Molecular Sciences.2023; 24(23): 17094. CrossRef

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