Mr Dale Coghlan1, Syeda Fatima1,2, Jonathan Craig1, Jacqueline Stephens1
1College of Medicine and Public Health, Flinders University, Adelaide, Australia, 2Global Ecology, Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, Australia
Biography:
As a Patient Engagement Officer, Dale is responsible for developing and coordinating a patient involvement framework within the BEAT-CKD network, ensuring the integration of perspectives and experiences of individuals living with kidney disease in all research activities. He provides administrative and operational support to project teams, overseeing the implementation and delivery of activities to achieve established milestones and deliverables
Aim:
To quantify the impact of ambient heat and heatwaves on CKD outcomes and identify populations most vulnerable to heat-related CKD risk.
Background:
Rising global temperatures and the increasing frequency of heatwaves pose significant public health challenges, particularly for chronic kidney disease (CKD). This systematic review and meta-analysis aimed to synthesise evidence on the association between ambient heat, heatwaves, and CKD outcomes.
Methods:
MEDLINE, Embase, Web of Science, and Scopus were searched for studies examining the impact of ambient heat or heatwaves on CKD outcomes. Eligible studies reported quantitative effect estimates and met predefined methodological criteria. Random-effects meta-analyses were conducted to pool relative risks per 1°C increase in temperature and for heatwave exposures. Heterogeneity was assessed using the I² statistic, and subgroup analyses explored effect modification by geography and occupational status. Publication bias was evaluated with Egger’s test and trim-and-fill.
Results:
Fifteen ambient-heat and seven heatwave studies were included. Each 1°C rise in ambient temperature was associated with a 1.8% increased risk of CKD-related outcomes (RR=1.018, 95% CI:1.008–1.029; I²=83.3%). Heatwave exposure showed a non-linear association, with extreme heatwaves (>97th percentile, ≥3 days) conferring the highest risk (RR=1.213, 95% CI:1.102–1.335). Subgroup analyses revealed stronger associations in tropical regions and among occupationally exposed groups. No evidence of publication bias was detected.
Conclusions:
Ambient heat and heatwaves are associated with increased risk of CKD outcomes, with the greatest vulnerability observed in tropical climates and among workers exposed to prolonged heat. Findings highlight the need for targeted public health interventions and workplace protections as climate change accelerates. Further research should prioritise prospective cohorts and mechanistic studies to inform adaptive strategies for CKD prevention in a warming world.