As daily temperatures increase, so does the number of patients seeking treatment for kidney stones. In a study that may both reflect and foretell a warming planet’s impact on human health, a research team found a link between hot days and kidney stones in 60,000 patients in several U.S. cities with varying climates.
“We found that as daily temperatures rise, there is a rapid increase in the probability of patients presenting over the next 20 days with kidney stones,” said the study’s first author Gregory E. Tasian, MD, MSc, MSCE, a pediatric urologist and epidemiologist at The Children’s Hospital of Philadelphia. Along with Ron Keren, MD, MPH, of the Center for Pediatric Clinical Effectiveness, Dr. Tasian published the study team’s findings recently in Environmental Health Perspectives, the journal of the National Institute of Environmental Health Sciences.
A painful condition that brings half a million patients a year to U.S. emergency rooms, kidney stones’ prevalence has increased markedly in the past three decades. While they remain more common in adults, the numbers of children developing kidney stones have climbed at a dramatically high rate over the last 25 years. When stones do not pass on their own, surgery may be necessary.
The investigators analyzed medical records of more than 60,000 adults and children with kidney stones between 2005 and 2011 in Atlanta, Chicago, Dallas, Los Angeles, and Philadelphia, in connection with weather data. Dr. Tasian and colleagues described the risk of stone presentation for the full range of temperatures in each city. The delay between high daily temperatures and kidney stone presentation was short, peaking within three days of exposure to hot days.
“These findings point to potential public health effects associated with global climate change,” said Dr. Tasian. “However,” he cautioned, “although 11 percent of the U.S. population has had kidney stones, most people have not. It is likely that higher temperatures increase the risk of kidney stones in those people predisposed to stone formation.” Higher temperatures contribute to dehydration, which leads to a higher concentration of calcium and other minerals in the urine that promote the growth of kidney stones.
The researchers also found that very low outdoor temperatures increased the risk of kidney stones in three cities: Atlanta, Chicago and Philadelphia. The authors suggest that as frigid weather keeps people indoors more, higher indoor temperatures, changes in diet, and decreased physical activity may increase their risk of kidney stones. Moreover, the researchers argue that the number of hot days in a given year may better predict kidney stone risk than the mean annual temperature.
Dr. Tasian added that while the five U.S. cities have climates representative of those found throughout the world, future studies should explore how generalizable the current findings are. Other studies should analyze how risk patterns vary in different populations, including among children, represented by a small sample size in the current study.
The study’s broader context is in patterns of global warming. The authors note that other scientists have reported that overall global temperatures between 2000 and 2009 were higher than 82 percent of temperatures over the previous 11,300 years. Furthermore, increases in greenhouse gas emissions are projected to raise average temperatures by 2 to 8 ͦF (1 to 4.5 ͦC) by 2100.
“Kidney stone prevalence has already been on the rise over the last 30 years, and we can expect this trend to continue, both in greater numbers and over a broader geographic area, as daily temperatures increase,” concluded Dr. Tasian. “With some experts predicting that extreme temperatures will become the norm in 30 years, children will bear the brunt of climate change.”