U.O.C. Nefrologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
U.O.C. Nefrologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Environ Health. 2021 Jan 15;20(1):8. doi: 10.1186/s12940-021-00691-5.
The aim of our study was to describe seasonal trends of acute kidney injury (AKI) and its relationship with weather conditions in a hospitalized population.
We retrospectively collected demographic (age, sex), clinical (ICD-9-CM codes of diagnosis discharge) and laboratory data (creatinine values) from the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 2010 and December 2014 with inclusion of all patients ≥18 years with at least two values available for creatinine. The outcome of interest was AKI development, defined according to creatinine kinetics criteria. The exposures of interest were the months and seasons of the year; air temperature and humidity level were also evaluated. Log-binomial regression models adjusted for age, sex, eGFR, comorbidities, Charlson/Deyo index score, year of hospitalization were used to estimate risk ratios (RR) and 95% confidential intervals (CI).
A total of 64,610 patients met the inclusion criteria. AKI occurred in 2864 (4.4%) hospital admissions. After full adjustment, winter period was associated with increased risk of AKI (RR 1.16, 95% CI 1.05, 1.29, p=0.003). Lower air temperature and higher humidity level were associated with risk of AKI, however in multivariable-adjusted models only higher humidity level showed a significant and independent association.
AKI is one of the most common complications of hospitalized populations with a defined seasonal pattern and a significant increase in incidence during wintertime; weather conditions, particularly higher humidity level, are independent predictors of AKI and could partially justify the observed seasonal variations.
本研究旨在描述住院人群中急性肾损伤（AKI）的季节性趋势及其与天气条件的关系。
我们回顾性地收集了 2010 年 1 月至 2014 年 12 月期间在 Fondazione Policlinico Universitario A. Gemelli IRCCS 住院的患者的人口统计学（年龄、性别）、临床（ICD-9-CM 诊断出院代码）和实验室数据（肌酐值），纳入所有年龄≥18 岁且至少有两次肌酐值的患者。研究的结局是 AKI 的发生，根据肌酐动力学标准定义。研究的暴露因素是一年中的月份和季节；还评估了空气温度和湿度水平。使用调整了年龄、性别、eGFR、合并症、Charlson/Deyo 指数评分和住院年份的对数二项式回归模型来估计风险比（RR）和 95%置信区间（CI）。
共有 64610 名患者符合纳入标准。在 2864 次住院治疗中发生了 AKI（4.4%）。经过完全调整后，冬季与 AKI 风险增加相关（RR 1.16，95%CI 1.05，1.29，p=0.003）。较低的空气温度和较高的湿度水平与 AKI 风险相关，但在多变量调整模型中，只有较高的湿度水平显示出显著且独立的相关性。
AKI 是住院人群中最常见的并发症之一，具有明确的季节性模式，冬季发病率显著增加；天气条件，特别是较高的湿度水平，是 AKI 的独立预测因素，部分解释了观察到的季节性变化。
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