title: Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy.
abstract: Climate change has led to significant rise of 0.8°C-0.9°C in global mean temperature over the last century and has been linked with significant increases in the frequency and severity of heat waves (extreme heat events). Climate change has also been increasingly connected to detrimental human health. One of the consequences of climate-related extreme heat exposure is dehydration and volume loss, leading to acute mortality from exacerbations of pre-existing chronic disease, as well as from outright heat exhaustion and heat stroke. Recent studies have also shown that recurrent heat exposure with physical exertion and inadequate hydration can lead to CKD that is distinct from that caused by diabetes, hypertension, or GN. Epidemics of CKD consistent with heat stress nephropathy are now occurring across the world. Here, we describe this disease, discuss the locations where it appears to be manifesting, link it with increasing temperatures, and discuss ongoing attempts to prevent the disease. Heat stress nephropathy may represent one of the first epidemics due to global warming. Government, industry, and health policy makers in the impacted regions should place greater emphasis on occupational and community interventions.
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material .
authors.forename: Jason
authors.initials: J
authors.lastname: Glaser
authors.forename: Jay
authors.initials: J
authors.lastname: Lemery
authors.forename: Balaji
authors.initials: B
authors.lastname: Rajagopalan
authors.forename: Henry F
authors.initials: HF
authors.lastname: Diaz
authors.forename: Ramón
authors.initials: R
authors.lastname: García-Trabanino
authors.forename: Gangadhar
authors.initials: G
authors.lastname: Taduri
authors.forename: Magdalena
authors.initials: M
authors.lastname: Madero
authors.forename: Mala
authors.initials: M
authors.lastname: Amarasinghe
authors.forename: Georgi
authors.initials: G
authors.lastname: Abraham
authors.forename: Sirirat
authors.initials: S
authors.lastname: Anutrakulchai
authors.forename: Vivekanand
authors.initials: V
authors.lastname: Jha
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
authors.forename: Carlos
authors.initials: C
authors.lastname: Roncal-Jimenez
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Lanaspa
authors.forename: Ricardo
authors.initials: R
authors.lastname: Correa-Rotter
authors.forename: David
authors.initials: D
authors.lastname: Sheikh-Hamad
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Burdmann
authors.forename: Ana
authors.initials: A
authors.lastname: Andres-Hernando
authors.forename: Tamara
authors.initials: T
authors.lastname: Milagres
authors.forename: Ilana
authors.initials: I
authors.lastname: Weiss
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
authors.forename: Catharina
authors.initials: C
authors.lastname: Wesseling
authors.forename: Laura Gabriela
authors.initials: LG
authors.lastname: Sánchez-Lozada
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D002489:Central America / Q000453:epidemiology; D057231:Climate Change; D003681:Dehydration / Q000209:etiology; D058872:Epidemics; D055874:Extreme Heat / Q000009:adverse effects*; D018882:Heat Stress Disorders / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D009656:North America / Q000453:epidemiology; D005082:Physical Exertion; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology; D013020:South America / Q000453:epidemiology; D013188:Sri Lanka / Q000453:epidemiology
keywords: Chronic; Climate; Climate Change; Dehydration; Health Policy; Heat Exhaustion; Hot Temperature; Physical Exertion; Renal Insufficiency; Rural Population; chronic kidney disease