Amorim Fabiano, Schlader Zachary
Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, New Mexico.
Department of Kinesiology.
Curr Opin Nephrol Hypertens. 2025 Mar 1;34(2):170-176. doi: 10.1097/MNH.0000000000001050. Epub 2024 Dec 13.
This review examines the effects of occupational heat stress on kidney health. It focuses on the role of hyperthermia in the development of acute kidney injury (AKI) and its potential progression to chronic kidney disease of nontraditional etiology (CKDnt). We highlight the physiological mechanisms by which hyperthermia affects kidney function and discuss emerging preventive strategies.
Hyperthermia places the kidneys in a vulnerable state. As body temperature increases, blood flow is directed toward the skin to aid in cooling, diverting it away from internal organs like the kidneys to support blood pressure regulation. At the same time, hyperthermia and dehydration increases energetic demand to promote fluid and electrolyte conservation. Collectively, this can create a localized supply-demand mismatch, resulting in tissue hypoxia that can damage kidney tissues. These findings highlight that heat hyperthermia can lead to subclinical kidney damage, with potential long-term implications for kidney health.
Heat-induced AKI is a growing public health concern. Individuals engaged in manual labor with prolonged exposure are at risk of CKDnt. Interventions aimed to prevent hyperthermia show promise in mitigating the risk of AKI. Further research is necessary to refine these strategies and establish evidence-based guidelines for reducing heat-related kidney injuries.
本综述探讨职业性热应激对肾脏健康的影响。重点关注高温在急性肾损伤（AKI）发生发展中的作用及其向非传统病因慢性肾脏病（CKDnt）进展的可能性。我们强调高温影响肾功能的生理机制，并讨论新兴的预防策略。
高温使肾脏处于脆弱状态。随着体温升高，血液流向皮肤以帮助散热，从而从肾脏等内部器官分流，以支持血压调节。与此同时，高温和脱水增加了能量需求，以促进液体和电解质的保留。总体而言，这会导致局部供需不匹配，从而造成组织缺氧，进而损害肾脏组织。这些发现表明，热应激可导致亚临床肾损伤，对肾脏健康具有潜在的长期影响。
热致急性肾损伤日益引起公众健康关注。长期从事体力劳动的个体有患非传统病因慢性肾脏病的风险。旨在预防高温的干预措施在减轻急性肾损伤风险方面显示出前景。有必要进一步研究以完善这些策略，并制定基于证据的指南以减少与热相关的肾损伤。
