Lee Woo-Seok, Kim Woo-Sung, Lim Youn-Hee, Hong Yun-Chul
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea.
J Prev Med Public Health. 2019 Jan;52(1):1-13. doi: 10.3961/jpmph.18.149. Epub 2018 Nov 20.
In recent years, serious concerns have been raised regarding the impacts of rising temperatures on health. The present study was conducted to investigate the relationship between elevated temperatures and kidney disease through a systematic review and meta-analysis.
In October 2017, 2 researchers independently searched related studies in PubMed and Embase. A meta-analysis was conducted using a random-effects model, including only studies that presented odds ratios, relative risks, or percentage changes, along with 95% confidence intervals (CIs). The characteristics of each study were summarized, and the Egger test and funnel plots were used to evaluate publication bias.
Eleven studies that met the criteria were included in the final analysis. The pooled results suggest an increase of 30% (95% CI, 20 to 40) in kidney disease morbidity with high temperatures. In a disease-specific subgroup analysis, statistically significant results were observed for both renal colic or kidney stones and other renal diseases. In a study design-specific subgroup analysis, statistically significant results were observed in both time-series analyses and studies with other designs. In a temperature measure-specific subgroup analysis, significant results were likewise found for both studies using mean temperature measurements and studies measuring heat waves or heat stress.
Our results indicate that morbidity due to kidney disease increases at high temperatures. We also found significant results in subgroup analyses. However, further time-series analyses are needed to obtain more generalizable evidence.
近年来,人们对气温上升对健康的影响提出了严重关切。本研究旨在通过系统评价和荟萃分析来调查气温升高与肾脏疾病之间的关系。
2017年10月,两名研究人员独立检索了PubMed和Embase上的相关研究。采用随机效应模型进行荟萃分析,仅纳入呈现比值比、相对风险或百分比变化以及95%置信区间(CIs)的研究。总结了每项研究的特征,并使用Egger检验和漏斗图来评估发表偏倚。
最终分析纳入了11项符合标准的研究。汇总结果表明,高温下肾脏疾病发病率增加了30%(95%CI,20%至40%)。在特定疾病亚组分析中,肾绞痛或肾结石以及其他肾脏疾病均观察到具有统计学意义的结果。在特定研究设计亚组分析中,时间序列分析和其他设计的研究均观察到具有统计学意义的结果。在特定温度测量亚组分析中,使用平均温度测量的研究以及测量热浪或热应激的研究同样发现了显著结果。
我们的结果表明,高温下肾脏疾病的发病率会增加。我们在亚组分析中也发现了显著结果。然而,需要进一步的时间序列分析以获得更具普遍性的证据。