2019-11-6

Temperature as a risk factor of emergency department visits for acute kidney injury: a case-crossover study in Seoul, South Korea

Satbyul Estella Kim, Hyewon Lee, Jayeun Kim, Young Kyu Lee, Minjin Kang, Yasuaki Hijioka, Ho Kim

Information of Paper

Temperature as a risk factor of emergency department visits for acute kidney injury: a case-crossover study in Seoul, South Korea

Author: Satbyul Estella Kim, Hyewon Lee, Jayeun Kim, Young Kyu Lee, Minjin Kang, Yasuaki Hijioka, Ho Kim
Year:2019
Journal:Environmental Health 18, 55

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Keywords

Ambient temperature, Acute kidney injury, Emergency department visit, Case-crossover design, Exposure-response curve

Abstract

Previous studies show that escalations in ambient temperature are among the risk factors for acute kidney injury (AKI). However, it has not been adequately studied in our location, Seoul, South Korea. In this study, we aimed to examine the association between ambient temperatures and AKI morbidity using emergency department (ED) visit data. We obtained data on ED visits from the National Emergency Medical Center for 21,656 reported cases of AKI from 2010 to 2014. Time-stratified case-crossover design analysis based on conditional logistic regression was used to analyze short-term effects of ambient temperature on AKI after controlling for relevant covariates. The shape of the exposure–response curve, effect modification by individual demographic characteristics, season, and comorbidities, as well as lag effects, were investigated. The odds ratio (OR) per 1 °C increase at lag 0 was 1.0087 (95% confidence interval [CI]: 1.0041–1.0134). Risks were higher during the warm season (OR = 1.0149; 95% CI: 1.0065–1.0234) than during the cool season (OR = 1.0059; 95% CI: 1.0003–1.0116) and even higher above 22.3 °C (OR = 1.0235; 95% CI: 1.0230–1.0239). This study provides evidence that ED visits for AKI were associated with ambient temperature. Early detection and treatment of patients at risk is important in both clinical and economic concerns related to AKI.

Figure1
Figure 1. Relationship between ambient temperature and risks of emergency department visits due to acute kidney injury in Seoul, South Korea, between 2010 and 2014 in (a) all seasons, (b) the warm season (April–September), and (c) the cool season (October–March)
Figure 2. Effects of temperature on emergency department visits for acute kidney injury by subgroups in Seoul, South Korea, from 2010 to 2014. The overall associations are estimated as odds ratios (ORs) with 95% confidence intervals per 1 °C increase in temperature. Adjusted for relative humidity, air pressure, and PM10 in the model. Abbreviations: AKI, acute kidney injury; < 65, < 65 years of age; 65+, ≥ 65 years of age; HD, hypertension disease; DB, diabetes

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