Associations between short-term ambient temperature exposure and kidney-related diseases in New York State: The influence of exposure spatial resolution and adaptation adjustment

Abstract

BACKGROUND AND AIM Findings on the relationship between short-term temperature exposure and kidney diseases are divergent. Furthermore, the roles of temperature spatial resolution and climate adaptation are unclear. This study aimed to evaluate associations between short-term ambient temperature exposure and kidney-related diseases, as well as the influence of spatial resolution and adaptation adjustment. METHODS We estimated daily mean temperature at 1-km resolution in New York State (NYS) from random forest models, and obtained health data from the NYS SPARCS dataset (2007-2016). We used a symmetric case-crossover design analyzed by conditional logistic regression with distributed lag non-linear models, and evaluated spatial resolutions of 1-km, 5-km, 10-km, 20-km, and 35-km. To evaluate the influence of adaptation, we compared one-stage and two-stage models using temperature on the absolute or relative scales. RESULTS This study included 1,209,934 non-elective adult kidney-related hospital visits. We observed similar estimates from models with different spatial resolutions. When controlling for adaptation in one-stage models using temperature on the relative scale at 20-km resolution, for the 95th percentile of daily mean temperature compared to the minimum morbidity temperature at lag 0-6 days, we found odds ratios of 1.14 for acute kidney failure (95% confidence interval [CI]: 1.07, 1.22), 1.10 for renal tubulo-interstitial diseases (95% CI: 1.02, 1.18), 1.21 for urolithiasis (95% CI: 1.16, 1.26), 1.25 for dysnatremia (95% CI: 1.14, 1.37), and 1.27 for volume depletion (95% CI: 1.23, 1.31), but no significant associations for chronic kidney disease (CKD) or glomerular diseases (GD). Models not considering adaptation generated consistent association patterns, but somewhat different effect estimates. CONCLUSIONS Short-term exposure to high temperature was associated with increased risk for kidney-related diseases (except CKD and GD). The influence of exposure spatial resolution was negligible and of adaptation adjustment was modest. KEYWORDS Temperature; kidney diseases; exposure assessment; adaptation