The worldwide increase in temperature has resulted in a marked increase in heat waves (heat extremes) that carries a markedly increased risk for morbidity and mortality. The kidney has a unique role not only in protecting the host from heat and dehydration but also is an important site of heat-associated disease. Here we review the potential impact of global warming and heat extremes on kidney diseases. High temperatures can result in increased core temperatures, dehydration, and blood hyperosmolality. Heatstroke (both clinical and subclinical whole-body hyperthermia) may have a major role in causing both acute kidney disease, leading to increased risk of acute kidney injury from rhabdomyolysis, or heat-induced inflammatory injury to the kidney. Recurrent heat and dehydration can result in chronic kidney disease (CKD) in animals and theoretically plays a role in epidemics of CKD developing in hot regions of the world where workers are exposed to extreme heat. Heat stress and dehydration also has a role in kidney stone formation, and poor hydration habits may increase the risk for recurrent urinary tract infections. The resultant social and economic consequences include disability and loss of productivity and employment. Given the rise in world temperatures, there is a major need to better understand how heat stress can induce kidney disease, how best to provide adequate hydration, and ways to reduce the negative effects of chronic heat exposure.

Annals of nutrition & metabolism. 2019 Jun 14 [Epub]

Richard J Johnson, Laura G Sánchez-Lozada, Lee S Newman, Miguel A Lanaspa, Henry F Diaz, Jay Lemery, Bernardo Rodriguez-Iturbe, Dean R Tolan, Jaime Butler-Dawson, Yuka Sato, Gabriela Garcia, Ana Andres Hernando, Carlos A Roncal-Jimenez

Division of Renal Diseases and Hypertension, University of Colorado, Aurora, Colorado, USA, ., Department of Nephrology, INC Ignacio Chavez, Mexico City, Mexico., Department of Environmental and Occupational Health, Center for Health, Work, and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA., Division of Renal Diseases and Hypertension, University of Colorado, Aurora, Colorado, USA., Department of Geography and Environment, University of Hawai’i at Mānoa, Honolulu, Hawaii, USA., Division of Wilderness Health, Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA., Universidad del Zulia, Maracaibo, Zulia, Venezuela., Department of Biochemistry, Boston University, Boston, Massachusetts, USA.