1
|
Bajpai D, Hailu W, Bagasha P, Chika OU, Hafiz E, Tannor EK, Wijewickrama E, Kalyesubula R, Karam S, Calice-Silva V, Ethier I, Sandal S. Challenges to Implementing Environmentally Sustainable Kidney Care in LMICs: An Opinion Piece. Can J Kidney Health Dis 2024; 11:20543581241246835. [PMID: 38774488 PMCID: PMC11107313 DOI: 10.1177/20543581241246835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Indexed: 05/24/2024] Open
Affiliation(s)
- Divya Bajpai
- Department of Nephrology, King Edward (VII) Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India
| | - Workagegnehu Hailu
- Unit of Nephrology, Department of Internal Medicine, University of Gondar, Ethiopia
| | - Peace Bagasha
- Directorate of Internal Medicine, Mulago National Specialized Hospital, Kampala, Uganda
| | | | - Ehab Hafiz
- Electron Microscopy Department, Clinical Laboratory Division, Theodor Bilharz Research Institute, Giza, Egypt
| | - Elliot Koranteng Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Renal Unit, Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Eranga Wijewickrama
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Robert Kalyesubula
- Department of Physiology, Makerere University and Mulago Hospital, Kampala, Uganda
| | - Sabine Karam
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Minnesota, Minneapolis, USA
- Division of Nephrology and Hypertension, Department of Medicine, American University of Beirut, Lebanon
| | - Viviane Calice-Silva
- Research Department, Pro-rim Foundation and School of Medicine, UNIVILLE, Joinville, Brazil
| | - Isabelle Ethier
- Division of Nephrology, Centre Hospitalier de l’Université de Montréal, Québec, Canada
- Health Innovation and Evaluation hub, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Québec, Canada
| | - Shaifali Sandal
- Divisions of Nephrology and Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
- MEDIC, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
2
|
Stoneman S, Balmer F, Moore L, Fontana M, Kielstein JT, Woywodt A. Meet and greet but avoid the heat: a reflection on the carbon footprint of congresses prompted by ERA2023. Clin Kidney J 2024; 17:sfae062. [PMID: 38699480 PMCID: PMC11063956 DOI: 10.1093/ckj/sfae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Indexed: 05/05/2024] Open
Affiliation(s)
- Sinead Stoneman
- Department of Nephrology, Cork University Hospital, Cork, Ireland
| | - Frances Balmer
- Sustainability Fellow, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| | - Louise Moore
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| | | | - Jan T Kielstein
- Medical Clinic V, Nephrology, Rheumatology and Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Germany
| | - Alexander Woywodt
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| |
Collapse
|
3
|
Hajat S, Casula A, Murage P, Omoyeni D, Gray T, Plummer Z, Steenkamp R, Nitsch D. Ambient heat and acute kidney injury: case-crossover analysis of 1 354 675 automated e-alert episodes linked to high-resolution climate data. Lancet Planet Health 2024; 8:e156-e162. [PMID: 38453381 DOI: 10.1016/s2542-5196(24)00008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND As global temperatures continue to rise, the effects of ambient heat on acute kidney injury (AKI) are of growing concern. We used a novel nationwide electronic alert (e-alert) system to detect increases in AKI risk associated with high temperatures. METHODS We used a case-crossover design to link 1 354 675 AKI episodes occurring in England between April and September in years 2017-2021 to daily maximum temperature data at postcode sector level. AKI episode data were obtained from the UK Renal Registry. There were no further inclusion or exclusion criteria. Conditional logistic regression employing distributed lag non-linear models was used to assess odds of AKI episode on case days compared with day-of-week matched control days. Effects during heatwaves were also assessed using heat-episode analysis. FINDINGS There were strongly increased odds of AKI episode associated with high temperatures, with odds ratio (OR) 1·623 (95% CI 1·319-1·997) on a day of temperature 32°C compared with one of 17°C, the effects being strongest on a lag of 1 day. There was an OR of 1·020 (1·019-1·020) per 1°C increase in temperature above 17°C. The odds of a heat-related AKI episode were similar between AKI stages 1 and 2, but considerably lower for stage 3 events. A 7-day heatwave in July 2021 was associated with a 28·6% increase in AKI counts (95% CI 26·5-30·7). INTERPRETATION Heat-related AKI is a growing public health challenge. As even small changes in renal function can affect patient outcomes, susceptible individuals should be advised to take preventive measures whenever hot weather is forecast. Use of an e-alert system allows effects in milder cases that do not require secondary care to also be detected. FUNDING National Institute for Health and Care Research (NIHR).
Collapse
Affiliation(s)
- Shakoor Hajat
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Anna Casula
- UK Renal Registry, UK Kidney Association, Bristol, UK
| | - Peninah Murage
- London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel Omoyeni
- London School of Hygiene & Tropical Medicine, London, UK
| | - Tom Gray
- UK Renal Registry, UK Kidney Association, Bristol, UK
| | - Zoe Plummer
- UK Renal Registry, UK Kidney Association, Bristol, UK
| | | | - Dorothea Nitsch
- London School of Hygiene & Tropical Medicine, London, UK; UK Renal Registry, UK Kidney Association, Bristol, UK
| |
Collapse
|
4
|
Goldfarb DS. Nephrologists should talk to their patients about climate change. Curr Opin Nephrol Hypertens 2024; 33:170-173. [PMID: 38240262 DOI: 10.1097/mnh.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- David S Goldfarb
- Nephrology Division, NYU Grossman School of Medicine and Nephrology Section, NY Harbor VA Healthcare System, New York, New York, USA
| |
Collapse
|
5
|
Dupuis L, Varshney A, Patel J, Joshi S. Climate crisis and nephrology: a review of climate change's impact on nephrology and how to combat it. Curr Opin Nephrol Hypertens 2024; 33:110-114. [PMID: 37909844 DOI: 10.1097/mnh.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Climate change is worsening with tangible effects on our healthcare system. This review aims to examine the repercussions of the climate change on nephrology and explore potential strategies to mitigate its impact. This review examines dialysis's environmental impact, resource recycling methods, and plant-based diets for kidney health. Recent research highlights the advantages of plant-based diets in managing and preventing chronic kidney disease (CKD) and its complications. Integrating these practices can significantly lessen the environmental impact of nephrology. PURPOSE OF REVIEW The aim of this study is to discuss the bidirectional relationship of climate change and kidney disease and the impact of nephrology on climate change and to discuss potential solutions. RECENT FINDINGS Each dialysis session consumes significant amounts of resource; reusing them will aid the environment. Plant-based diets slow renal disease and have a lower carbon footprint, making them ecologically friendly. SUMMARY Climate change is a growing threat to population health and healthcare. Rising temperatures raise the risk of kidney problems. Dialysis treatments also impact the environment through its high resource requirements while generating high volumes of waste and greenhouse gases. Opportunities exist to reduce the environmental impact of dialysis treatments. Plant-based diets serve to benefit both kidney disease and the environment.
Collapse
Affiliation(s)
- Leonie Dupuis
- Vanderbilt University Medical Center, Department of Medicine, Nashville, Tennessee
| | - Aarushi Varshney
- University of Central Florida HCA Healthcare GME, Greater Orlando
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, Florida
| | - Jason Patel
- University of Arizona College of Medicine - Phoenix, Phoenix, Arizona
| | - Shivam Joshi
- Orlando VA Medical Center, Orlando, Florida
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
6
|
Alvarez-Elias AC, Brenner BM, Luyckx VA. Climate change and its influence in nephron mass. Curr Opin Nephrol Hypertens 2024; 33:102-109. [PMID: 37800660 PMCID: PMC10715706 DOI: 10.1097/mnh.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
PURPOSE OF REVIEW The consequences of climate change, including heat and extreme weather events impact kidney function in adults and children. The impacts of climate change on kidney development during gestation and thereby on kidney function later in life have been poorly described. Clinical evidence is summarized to highlight possible associations between climate change and nephron mass. RECENT FINDINGS Pregnant women are vulnerable to the effects of climate change, being less able to thermoregulate, more sensitive to the effects of dehydration, and more susceptible to infections. Exposure to heat, wildfire smoke, drought, floods and climate-related infections are associated with low birth weight, preterm birth and preeclampsia. These factors are associated with reduced nephron numbers, kidney dysfunction and higher blood pressures in offspring in later life. Exposure to air pollution is associated with higher blood pressures in children and has variable effects on estimated glomerular filtration rate. SUMMARY Climate change has important impacts on pregnant women and their unborn children. Being born too small or too soon is associated with life-time risk of kidney disease. Climate change may therefore have a dual effect of impacting fetal kidney development and contributing to cumulative postnatal kidney injury. The impact on population kidney health of future generations may be significant.
Collapse
Affiliation(s)
- Ana Catalina Alvarez-Elias
- Renal Research Institute, New York City, New York, USA
- Hospital Infantil de México, Federico Gómez, Mexico City, Mexico
- University of Toronto, IHPME & Sick Kids Research Institute, Toronto, Canada
| | - Barry M. Brenner
- Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Valerie A. Luyckx
- Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
7
|
Karam S, Gunasekara VN, Abou Jaoudeh P, Wijewickrama E. Preparing for the Unexpected, Supporting the Vulnerable-A Perspective From Lebanon and Sri Lanka. Kidney Int Rep 2023; 8:383-387. [PMID: 36938072 PMCID: PMC10014372 DOI: 10.1016/j.ekir.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA
- Correspondence: Sabine Karam, Division of Nephrology and Hypertension, 717 Delaware Street SE Suite 353B, Minneapolis, Minnesota 55414, USA.
| | | | | | - Eranga Wijewickrama
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- National Hospital of Sri Lanka, Colombo, Sri Lanka
| |
Collapse
|
8
|
Kamel Boulos MN, Wilson JP. Geospatial techniques for monitoring and mitigating climate change and its effects on human health. Int J Health Geogr 2023; 22:2. [PMID: 36707823 PMCID: PMC9883899 DOI: 10.1186/s12942-023-00324-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
This article begins by briefly examining the multitude of ways in which climate and climate change affect human health and wellbeing. It then proceeds to present a quick overview of how geospatial data, methods and tools are playing key roles in the measurement, analysis and modelling of climate change and its effects on human health. Geospatial techniques are proving indispensable for making more accurate assessments and estimates, predicting future trends more reliably, and devising more optimised climate change adaptation and mitigation plans.
Collapse
Affiliation(s)
- Maged N. Kamel Boulos
- Co-Chair, WG III/9 Geospatial Environment and Health Analytics, ISPRS Technical Commission III, 30167 Hannover, Germany ,grid.9983.b0000 0001 2181 4263School of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - John P. Wilson
- grid.42505.360000 0001 2156 6853Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089-0374 USA
| |
Collapse
|