New research, supported by the National Institute of Health and La Isla Network, considers the impact of climate change on kidney health, as well as the broader effect this will have on the discipline of nephrology.

We recently sat down with one author on the study, Dr. Richard J Johnson, Tomas Berl Professor of Medicine at the University of Colorado Anschutz Medical Campus to discuss the findings and their implications for the millions of workers currently exposed to extreme heat.

Richard, could you give us some background on your area of research?

I have had a longstanding interest in what causes Kidney Disease and around 2010 became interested in the epidemics of kidney disease that were occurring in Central America and Sri Lanka. It was evident that these individuals were under a lot of heat stress, but up to that time there had been little evidence that heat stress could cause chronic kidney disease. We decided to do studies in laboratory animals, and found that chronic heat stress could cause kidney disease that had a similar appearance as the kidney disease in these regions. This triggered both experimental and clinical studies to determine if heat stress and exertion could have a major role. Among other things, we also were able to link the disease with climate change and increasing temperatures worldwide.

Why is climate change a concern for kidney health?

The kidneys have a major role in protecting the body from heat stress and dehydration, but at the same time, the kidney is also a target of heat stress. Heat stress not only causes both acute and chronic kidney damage, but can affect the electrolyte and water balance in our body that is normally controlled by the kidneys. The kidneys could be argued to be the conductor of the body orchestra that responds to heat stress.

What role do you see nephrologists playing in addressing the risks posed by climate change?

Kidney specialists not only deal with kidney disease, but also with water and electrolyte abnormalities. Along with emergency room physicians, the nephrologist is likely to see many of the individuals who suffer from the health effects of heat stress.

What is the main takeaway you hope that people get from this paper?

Climate change is not about the future, it also is here now. It is time for physicians, and especially nephrologists, to become acquainted with how heat stress and climate change can cause kidney disease and water and electrolyte abnormalities.

Richard, closing thoughts: what actions would you like to see in the coming future to ensure kidney health is protected in a warming world?

We need to have a multipronged attack- with more education of physicians and physicians in training, more research on the mechanisms of disease, more clinical trials to identify new therapies, and more preparedness and interventions at the public health and clinical sectors to prevent heat stress and to ensure optimal management.

Dr Richard J. Johnson, MD, is a Tomas Berl Professor of Medicine in the Division of Renal Diseases and Hypertension at the University of Colorado – Anschutz Medical Campus.

Read the article