Abstract：
Extreme heat exposure is associated with multiple diseases. However, our current understanding of the specific impact of extreme heat exposure on kidney disease is limited.
Case-crossover study.
1,114,322 emergency department (ED) visits with a principal diagnosis of kidney disease were identified in New York state, 2005-2013.
Extreme heat exposure was defined as when the daily temperature exceeded the 90th percentile temperature of that month during the study period in the county.
ED visits with a principal diagnosis of kidney disease and its subtypes (ICD-9 [International Classification of Diseases, Ninth Revision] codes 580-599, 788).
Extreme heat exposure on the ED visit days was compared with extreme heat exposure on control days using a conditional logistic regression model, controlling for humidity, air pollutants, and holidays. The excess risk of kidney disease was calculated for a week (lag days 0-6) after extreme heat exposure during the warm season (May through September). We also stratified our estimates by sociodemographic characteristics.
Extreme heat exposure was associated with a 1.7% (lag day 0) to 3.1% (lag day 2) higher risk of ED visits related to kidney disease; this association was stronger with a greater number of extreme heat exposure days in the previous week. The association with extreme heat exposure lasted for an entire week and was stronger in the transitional months (ie, May and September; excess rates ranged from 1.8% to 5.1%) rather than the summer months (June through August; excess rates ranged from 1.5% to 2.7%). The strength of association was greater among those with ED visits related to acute kidney injury, kidney stones, and urinary tract infections. Age and sex may modify the association between extreme heat exposure and ED visits.
Individual exposure to heat-how long people were outside or whether they had access to air conditioning-was unknown.
Extreme heat exposure was significantly associated with a dose-dependent greater risk of ED visits for kidney disease.
Case-crossover study.
1,114,322 emergency department (ED) visits with a principal diagnosis of kidney disease were identified in New York state, 2005-2013.
Extreme heat exposure was defined as when the daily temperature exceeded the 90th percentile temperature of that month during the study period in the county.
ED visits with a principal diagnosis of kidney disease and its subtypes (ICD-9 [International Classification of Diseases, Ninth Revision] codes 580-599, 788).
Extreme heat exposure on the ED visit days was compared with extreme heat exposure on control days using a conditional logistic regression model, controlling for humidity, air pollutants, and holidays. The excess risk of kidney disease was calculated for a week (lag days 0-6) after extreme heat exposure during the warm season (May through September). We also stratified our estimates by sociodemographic characteristics.
Extreme heat exposure was associated with a 1.7% (lag day 0) to 3.1% (lag day 2) higher risk of ED visits related to kidney disease; this association was stronger with a greater number of extreme heat exposure days in the previous week. The association with extreme heat exposure lasted for an entire week and was stronger in the transitional months (ie, May and September; excess rates ranged from 1.8% to 5.1%) rather than the summer months (June through August; excess rates ranged from 1.5% to 2.7%). The strength of association was greater among those with ED visits related to acute kidney injury, kidney stones, and urinary tract infections. Age and sex may modify the association between extreme heat exposure and ED visits.
Individual exposure to heat-how long people were outside or whether they had access to air conditioning-was unknown.
Extreme heat exposure was significantly associated with a dose-dependent greater risk of ED visits for kidney disease.
摘要：
目的：极端热暴露与多种疾病有关。然而,我们目前对极端热暴露对肾脏疾病的具体影响的了解有限.
方法：病例交叉研究。
方法：在纽约州确定了1,114,322例主要诊断为肾脏疾病的急诊科（ED）就诊，2005-2013年。
方法：极端热暴露定义为在该县的研究期间，每日温度超过该月的第90百分位数温度。
结果：主要诊断为肾脏疾病及其亚型的ED访视（ICD-9[国际疾病分类，第九次修订]代码580-599、788)。
方法：使用条件逻辑回归模型将ED就诊日的极端热暴露与对照日的极端热暴露进行比较，控制湿度，空气污染物,和假期。在温暖季节（5月至9月）极端热暴露后一周（滞后0-6天）计算肾脏疾病的额外风险。我们还根据社会人口统计学特征对我们的估计进行了分层。
结果：极端热暴露与肾脏疾病相关的ED就诊风险增加1.7%(滞后第0天)至3.1%(滞后第2天)；随着前一周极端热暴露天数的增加，这种关联更强。与极端热暴露的关联持续了整整一周，并且在过渡月份中更强（即，5月和9月；超额利率从1.8%到5.1%不等），而不是夏季（6月到8月；超额利率从1.5%到2.7%不等）。与急性肾损伤相关的急诊就诊者的关联强度更大，肾结石,和尿路感染.年龄和性别可能会改变极端热暴露与ED就诊之间的关联。
结论：个人暴露于热量-人们在外面多长时间或是否可以使用空调-是未知的。
结论：极端热暴露与肾脏疾病ED就诊的剂量依赖性较大风险显著相关。
方法：病例交叉研究。
方法：在纽约州确定了1,114,322例主要诊断为肾脏疾病的急诊科（ED）就诊，2005-2013年。
方法：极端热暴露定义为在该县的研究期间，每日温度超过该月的第90百分位数温度。
结果：主要诊断为肾脏疾病及其亚型的ED访视（ICD-9[国际疾病分类，第九次修订]代码580-599、788)。
方法：使用条件逻辑回归模型将ED就诊日的极端热暴露与对照日的极端热暴露进行比较，控制湿度，空气污染物,和假期。在温暖季节（5月至9月）极端热暴露后一周（滞后0-6天）计算肾脏疾病的额外风险。我们还根据社会人口统计学特征对我们的估计进行了分层。
结果：极端热暴露与肾脏疾病相关的ED就诊风险增加1.7%(滞后第0天)至3.1%(滞后第2天)；随着前一周极端热暴露天数的增加，这种关联更强。与极端热暴露的关联持续了整整一周，并且在过渡月份中更强（即，5月和9月；超额利率从1.8%到5.1%不等），而不是夏季（6月到8月；超额利率从1.5%到2.7%不等）。与急性肾损伤相关的急诊就诊者的关联强度更大，肾结石,和尿路感染.年龄和性别可能会改变极端热暴露与ED就诊之间的关联。
结论：个人暴露于热量-人们在外面多长时间或是否可以使用空调-是未知的。
结论：极端热暴露与肾脏疾病ED就诊的剂量依赖性较大风险显著相关。
