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IJE Advance Access originally published online on August 18, 2008
International Journal of Epidemiology 2008 37(6):1359-1365; doi:10.1093/ije/dyn165
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia

Alana L Hansen1, Peng Bi1,*, Philip Ryan1, Monika Nitschke2, Dino Pisaniello1 and Graeme Tucker2

1 Discipline of Public Health, School of Population Health and Clinical Practice, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia.
2 South Australian Department of Health, Adelaide, SA, Australia.

* Corresponding author. Discipline of Public Health, School of Population Health and Clinical Practice, Faculty of Health Sciences, Level 9, Tower Building, 10 Pulteney Street (MPD 207), The University of Adelaide, Adelaide, SA 5005, Australia. E-mail: peng.bi{at}adelaide.edu.au


   Abstract

Background A rarely investigated consequence of heat exposure is renal dysfunction resulting from dehydration and hyperthermia. Our study aims to quantify the relationship between exposure to extreme high temperatures and renal morbidity in South Australia.

Methods Poisson regression accounting for over dispersion, seasonality and long-term trend was used to estimate the effect of heat waves on hospital admissions for renal disease, acute renal failure and renal dialysis over a 12-year period. Selected comorbidities were investigated as possible contributing risk factors.

Results Admissions for renal disease and acute renal failure were increased during heat waves compared with non-heat wave periods with an incidence rate ratio of 1.100 [95% confidence intervals (CI) 1.003–1.206] and 1.255 (95% CI 1.037–1.519), respectively. Hospitalizations for dialysis showed no corresponding increase. Comorbid diabetes did not increase the risk of renal admission, however ‘effects of heat and light’ and ‘exposure to excessive natural heat’ (collectively termed effects of heat) were identified as risk factors.

Conclusion Our findings suggest that as heat waves become more frequent, the burden of renal morbidity may increase in susceptible individuals as an indirect consequence of global warming.


Keywords Acute renal failure, heat waves, global warming, kidney disease, weather

Accepted 17 July 2008


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