1. Could climate change affect my kidneys long term? YES it could!!!
#NephMadness #GreenRegion #ClimateChangeAndCKD
In the last 50 years β π temperature increased about 0.8Β°C π±
data.giss.nasa.gov
#NephMadness #GreenRegion #ClimateChangeAndCKD
In the last 50 years β π temperature increased about 0.8Β°C π±
data.giss.nasa.gov
2. #ClimateChange
β increase in extreme heat events #HeatWaves π
β consequences on human health π€
karger.com
β increase in extreme heat events #HeatWaves π
β consequences on human health π€
karger.com
3. Kidneys are not the exception:
High metabolic work + concentrated excretion of wastes make them susceptible to injury for #ClimateChange
In rural hot π‘οΈ communities there has been an β in CKD that is not associated with traditional risk factors
nejm.org
High metabolic work + concentrated excretion of wastes make them susceptible to injury for #ClimateChange
In rural hot π‘οΈ communities there has been an β in CKD that is not associated with traditional risk factors
nejm.org
4. Where has this phenomenon been reported?
5. CKD of unknown etiology (CKDu) has been recognized in regions of Central America, Mexico, Sri Lanka, India & Egypt by different names:
- Central America β Mesoamerican Nephropathy
- Sri Lanka β Sri Lankan Nephroathy
- India β Uddanam Nephropathy
nejm.org
- Central America β Mesoamerican Nephropathy
- Sri Lanka β Sri Lankan Nephroathy
- India β Uddanam Nephropathy
nejm.org
6. The term chronic interstitial nephritis in agricultural communities (CINAC), has been proposed to englobe them.
kireports.org
kireports.org
7. How do these patients develop CKD?
The mechanism is unclear, but some biopsies shows β chronic tubulointerstitial disease β Heat Stress Nephropathy
The mechanism is unclear, but some biopsies shows β chronic tubulointerstitial disease β Heat Stress Nephropathy
8. Let's talk more about #MesoamericanNephropathy, where was this entity first reported?
9. First reported in El Salvador in 2002, #MesoamericanNephropathy is an example of a disease that is accelerated by global warming ππ‘οΈ
10. Which of the following has been linked with #MesoamericanNephropathy?
11. The etiology is not entirely clear:
- Was thought to be caused by a toxin (agrochemicals, heavy metals, from infectious agents)
- But has been linked with recurrent dehydration and heat stress
- Sugarcane workers are particularly at risk.
- Was thought to be caused by a toxin (agrochemicals, heavy metals, from infectious agents)
- But has been linked with recurrent dehydration and heat stress
- Sugarcane workers are particularly at risk.
12. In Sri Lanka, others factors have been implicated:
- Environmental pollution (heavy metals & agrochemicals)
- Excess fluoride in water
- Sodium/calcium imbalance in water
- Genetic factors
- Environmental pollution (heavy metals & agrochemicals)
- Excess fluoride in water
- Sodium/calcium imbalance in water
- Genetic factors
13. Dehydration and recurrent volume depletion are correlated with repeated AKI episodes, but may also cause CKD via other mechanisms:
cjasn.asnjournals.org
cjasn.asnjournals.org
14. Dehydration & hyperthermia β hyperosmolarity + vasopressin + hyperuricemia + rhabdomyolysis = CKD progression
15. But beside dehydration β drinking fructose-containing sugary beverages π§, could exacerbate kidney injury via:
- Local tubular injury
- Inflammation
- Oxidative stress
- Stimulates vasopressin
- Local tubular injury
- Inflammation
- Oxidative stress
- Stimulates vasopressin
16. Experimental studies in π have shown that rehydration with soft drinks could enhance kidney damage.
bmcnephrol.biomedcentral.com
bmcnephrol.biomedcentral.com
17. Take home pointsπ
- Climate change affects kidney health long term
- In hot regions there has been an increase in CKDu
- Biopsies show chronic tubulointerstitial disease
- CKD occurs by multiple mechanisms (dehydration and heat stress are principal risk factors)
- Climate change affects kidney health long term
- In hot regions there has been an increase in CKDu
- Biopsies show chronic tubulointerstitial disease
- CKD occurs by multiple mechanisms (dehydration and heat stress are principal risk factors)
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