PDF(Pubmed)
Abstract：
UNASSIGNED: Previous studies have indicated that renal disease mortality is sensitive to ambient temperatures. However, most have been limited to the summer season with inconclusive evidence for changes in population vulnerability over time.
UNASSIGNED: This study aims to examine the association between short-term exposure to ambient temperatures and mortality due to renal diseases in Japan, and how this association varied over time.
UNASSIGNED: We conducted a two-stage, time-stratified case-crossover study from 1979 to 2019 across 47 prefectures of Japan. We obtained the data of daily mortality counts for all renal diseases, acute renal failure, and chronic renal disease. We fitted a conditional quasi-Poisson regression model with a distributed lag nonlinear model. A random-effects meta-analysis was applied to calculate national averages. We performed additional analyses by four subperiods, sex, and age groups.
UNASSIGNED: We analyzed 997,590 renal mortality cases and observed a reversed J-shaped association. Lower temperatures were associated with increased mortality in all renal disease categories. The cumulative relative risks at 2.5th percentile compared to the minimum mortality temperature percentile were 1.34 (95% confidence interval [CI] = 1.29, 1.40), 1.51 (95% CI = 1.33, 1.71), and 1.33 (95% CI = 1.24, 1.43) for all renal, acute renal failure, and chronic renal disease mortality, respectively. The associations were observed in individuals of both sexes and aged 65 years and above. The associations of kidney mortality with low temperature remained consistent, while the associations with high temperature were pronounced in the past, but not in recent periods.
UNASSIGNED: Protection for individuals with impaired renal function from exposure to low temperatures during cold seasons is warranted.
UNASSIGNED: This study aims to examine the association between short-term exposure to ambient temperatures and mortality due to renal diseases in Japan, and how this association varied over time.
UNASSIGNED: We conducted a two-stage, time-stratified case-crossover study from 1979 to 2019 across 47 prefectures of Japan. We obtained the data of daily mortality counts for all renal diseases, acute renal failure, and chronic renal disease. We fitted a conditional quasi-Poisson regression model with a distributed lag nonlinear model. A random-effects meta-analysis was applied to calculate national averages. We performed additional analyses by four subperiods, sex, and age groups.
UNASSIGNED: We analyzed 997,590 renal mortality cases and observed a reversed J-shaped association. Lower temperatures were associated with increased mortality in all renal disease categories. The cumulative relative risks at 2.5th percentile compared to the minimum mortality temperature percentile were 1.34 (95% confidence interval [CI] = 1.29, 1.40), 1.51 (95% CI = 1.33, 1.71), and 1.33 (95% CI = 1.24, 1.43) for all renal, acute renal failure, and chronic renal disease mortality, respectively. The associations were observed in individuals of both sexes and aged 65 years and above. The associations of kidney mortality with low temperature remained consistent, while the associations with high temperature were pronounced in the past, but not in recent periods.
UNASSIGNED: Protection for individuals with impaired renal function from exposure to low temperatures during cold seasons is warranted.
摘要：
■先前的研究表明，肾脏疾病死亡率对环境温度敏感。然而,大多数仅限于夏季，没有确凿的证据表明人口脆弱性随时间的变化。
■本研究旨在研究日本短期暴露于环境温度与因肾脏疾病导致的死亡率之间的关联。以及这种联系如何随着时间的推移而变化。
■我们进行了两个阶段，1979年至2019年日本47个县的时间分层病例交叉研究。我们获得了所有肾脏疾病的每日死亡率计数数据，急性肾功能衰竭,和慢性肾脏疾病。我们用分布滞后非线性模型拟合了条件拟泊松回归模型。采用随机效应荟萃分析计算全国平均水平。我们按四个子周期进行了额外的分析，性别,和年龄组。
■我们分析了997,590例肾脏死亡病例，观察到反向J形关联。在所有肾脏疾病类别中，较低的温度与死亡率增加有关。与最低死亡率温度百分位数相比，第2.5百分位数的累积相对风险为1.34（95％置信区间[CI]=1.29，1.40），1.51（95%CI=1.33，1.71），和1.33（95%CI=1.24，1.43），急性肾功能衰竭,和慢性肾病死亡率，分别。在性别和65岁及以上的个体中观察到了这种关联。肾脏死亡率与低温的关系仍然是一致的，虽然与高温的联系在过去很明显，但不是在最近的时期。
■保护肾功能受损的人在寒冷季节不暴露在低温下是必要的。
■本研究旨在研究日本短期暴露于环境温度与因肾脏疾病导致的死亡率之间的关联。以及这种联系如何随着时间的推移而变化。
■我们进行了两个阶段，1979年至2019年日本47个县的时间分层病例交叉研究。我们获得了所有肾脏疾病的每日死亡率计数数据，急性肾功能衰竭,和慢性肾脏疾病。我们用分布滞后非线性模型拟合了条件拟泊松回归模型。采用随机效应荟萃分析计算全国平均水平。我们按四个子周期进行了额外的分析，性别,和年龄组。
■我们分析了997,590例肾脏死亡病例，观察到反向J形关联。在所有肾脏疾病类别中，较低的温度与死亡率增加有关。与最低死亡率温度百分位数相比，第2.5百分位数的累积相对风险为1.34（95％置信区间[CI]=1.29，1.40），1.51（95%CI=1.33，1.71），和1.33（95%CI=1.24，1.43），急性肾功能衰竭,和慢性肾病死亡率，分别。在性别和65岁及以上的个体中观察到了这种关联。肾脏死亡率与低温的关系仍然是一致的，虽然与高温的联系在过去很明显，但不是在最近的时期。
■保护肾功能受损的人在寒冷季节不暴露在低温下是必要的。
