Su Wei-Yu, Wu Ping-Hsun, Lin Ming-Yen, Wu Pei-Yu, Tsai Yi-Chun, Chiu Yi-Wen, Chang Jer-Ming, Hung Chih-Hsing, Wu Chih-Da, Kuo Chao-Hung, Chen Szu-Chia
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Clin Kidney J. 2024 Jun 22;17(7):sfae173. doi: 10.1093/ckj/sfae173. eCollection 2024 Jul.
The worldwide prevalence and incidence rates of end-stage renal disease have been increasing, and the trend is pronounced in Taiwan. This is especially evident in southern Taiwan, where the wet-bulb globe temperature (WBGT) is consistently higher than in other regions. The association between kidney function and WBGT has not been fully investigated. Therefore, the aim of this study was to evaluate the association between estimated glomerular filtration rate (eGFR) and WBGT and variations in this association across different geographic regions in Taiwan. We used the Taiwan Biobank (TWB) to obtain data on community-dwelling individuals, linked these data with WBGT data obtained from the Central Weather Bureau and then processed the data using a machine learning model. WBGT data were recorded during the working period of the day from 8:00 a.m. to 5:00 p.m. These data were then compiled as 1-year, 3-year and 5-year averages, recorded prior to the survey year of the TWB of each participant. We identified 114 483 participants who had WBGT data during 2012-2020. Multivariable analysis showed that, in northern Taiwan, increases in 1- and 3-year averages of WBGT during the working period (β = -0.092, = .043 and β = -0.193, < .001, respectively) were significantly associated with low eGFR. In southern Taiwan, increases in 1-, 3- and 5-year averages of WBGT during the working period (β = -0.518, < .001; β = -0.690, < .001; and β = -0.386, = .001, respectively) were gnificantly associated with low eGFR. These findings highlight the importance of heat protection for people working outdoors or in high-temperature environments as a measure to prevent negative impacts on kidney function. Moreover, we observed that in southern Taiwan, every 1°C increase in WBGT had a greater impact on the decrease in eGFR compared with other regions in Taiwan.
终末期肾病的全球患病率和发病率一直在上升,在台湾这一趋势尤为明显。这在台湾南部尤为显著,那里的湿球黑球温度(WBGT)始终高于其他地区。肾功能与WBGT之间的关联尚未得到充分研究。因此,本研究的目的是评估估计肾小球滤过率(eGFR)与WBGT之间的关联,以及这种关联在台湾不同地理区域的差异。我们利用台湾生物银行(TWB)获取社区居住个体的数据,将这些数据与从中央气象局获得的WBGT数据相链接,然后使用机器学习模型处理这些数据。WBGT数据在上午8:00至下午5:00的工作日期间记录。然后将这些数据汇编为1年、3年和5年的平均值,记录在每个参与者TWB调查年份之前。我们确定了114483名在2012 - 2020年期间有WBGT数据的参与者。多变量分析表明,在台湾北部,工作日期间WBGT的1年和3年平均值增加(β = -0.092,P = 0.043;β = -0.193,P < 0.001)与低eGFR显著相关。在台湾南部,工作日期间WBGT的1年、3年和5年平均值增加(β = -0.518,P < 0.001;β = -0.690,P < 0.001;β = -0.386,P = 0.001)与低eGFR显著相关。这些发现凸显了对户外工作或在高温环境中工作的人进行热防护的重要性,以此作为防止对肾功能产生负面影响的一项措施。此外,我们观察到,在台湾南部,与台湾其他地区相比,WBGT每升高1°C对eGFR下降的影响更大。