Effect of ambient heat on chronic kidney disease and end-stage kidney disease among US veterans
Effect of ambient heat on chronic kidney disease and end-stage kidney disease among US veterans
批准号:
10653610
负责人:
Abu Mohammed Naser Titu
金额:
$43.33万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2023
资助国家:
美国
项目状态:
未结题
起止时间:
2023-05-01 至 2026-04-30
关键词:
Accident and Emergency departmentAcuteAcute Renal Failure with Renal Papillary NecrosisAdultAlbuminsAlbuminuriaBiological MarkersBloodBlood Urea NitrogenBlood ViscosityCaringChronicChronic Kidney FailureCitiesClimateClinicalCommunitiesCongestive Heart FailureCreatinineDataData SetDevelopmentDiagnosisDiseaseDisease ProgressionElectrolytesEnd stage renal failureEnvironmental Risk FactorEpidemiologyExposure toFunctional disorderFutureGeneral PopulationGlomerular Filtration RateGoalsHealthHeat Stress DisordersHeat StrokeHeat WavesHematocrit procedureHospitalsHumidityHypernatremiaIndividualKidney DiseasesKidney FailureKnowledgeLinkLogisticsMeasurementMeasuresMediatingMediationMedicareMissionModelingMonitorNational Institute of Environmental Health SciencesOnset of illnessOutcomePathway interactionsPatientsPersonsPlanet EarthPopulationProteinuriaPublic HealthRaceRenal functionResearchRoleSpecific GravitySweatingTemperatureUrineVeteransVisitWateradaptive interventioncardiovascular risk factorclimate changecohortcomorbiditycostdata modelingdesignexperienceextreme heathealth datameteorological datamilitary veteranmortalitypopulation healthpreventrenal damagespatiotemporal
中文摘要
项目总结
英文摘要
Project Summary
Chronic kidney disease (CKD) poses a significant health burden for the US population: 15% of the US adults,
or 37 million people, are estimated to have CKD. Among CKD's modifiable environmental risk factors,
exposure to high ambient heat has been linked to nephropathies in the US and globally, particularly in the
context of global climate change. Our current understanding of the effect of heat exposure on nephropathies
among the US population is limited, as we have only data on extreme heat exposure on acute kidney damage
and mortality from the emergency room or hospital visits. This application aims to evaluate the relationship
between ambient heat and new-onset CKD, its progression to end-stage kidney disease (ESKD), and the
underlying pathophysiological pathways in a large-scale nationwide cohort who had no kidney disease. We will
link spatiotemporally link the gridded Parameter-elevation Relationships on Independent Slopes Model
(PRISM) dataset of metrological variables with the health outcomes of the Racial and Cardiovascular Risk
Anomalies in CKD (RCAV) cohort of the VA population to accomplish our goal. We plan to use logistic mixed-
effect regression with cubic regression splines to determine the association between lagged ambient
temperature with incident CKD and ESKD, and causal mediation analyses to explore the biomarkers' mediated
effects of significant pathophysiological pathways. Our proposal will disentangle the role of ambient heat on the
new development and progression of nephropathies and increase our understanding of the mechanistic
pathways of ambient heat-related nephropathies ─ an emerging public health threat to the US and global
communities. Our results will positively impact designing heat adaptive interventions by clinicians, public health
managers, and the general public, as we will likely live with a higher number of days with increased ambient
heat in the future in a changing climate.
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