Renal Research Institute, New York City, New York, USA.
Hospital Infantil de México, Federico Gómez, Mexico City, Mexico.
Curr Opin Nephrol Hypertens. 2024 Jan 1;33(1):102-109. doi: 10.1097/MNH.0000000000000932. Epub 2023 Oct 6.
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.
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.
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.
目的综述：气候变化的影响，包括高温和极端天气事件，会对成人和儿童的肾脏功能产生影响。气候变化对妊娠期肾脏发育的影响，进而对生命后期肾脏功能的影响，尚未得到充分描述。本文总结了临床证据，以强调气候变化与肾单位数量之间可能存在的关联。
最新发现：孕妇易受气候变化的影响，她们的体温调节能力较差，对脱水的敏感性更高，更容易感染。暴露于高温、野火烟雾、干旱、洪水和与气候相关的感染与低出生体重、早产和子痫前期有关。这些因素与后代出生后肾单位数量减少、肾功能障碍和血压升高有关。暴露于空气污染与儿童血压升高有关，对估算肾小球滤过率的影响也各不相同。
总结：气候变化对孕妇及其未出生的孩子有重要影响。出生时体重过轻或过早出生与终生患肾脏疾病的风险相关。因此，气候变化可能会对胎儿肾脏发育产生双重影响，并导致累积性的产后肾脏损伤。这可能对后代的人口肾脏健康产生重大影响。
