Ten tips on how to care for your CKD patients in episodes of extreme heat

Abstract

Climate change is responsible for approximately 75% of extreme heat events throughout the world. Heat events are associated with an increased risk for acute kidney injury (AKI), which contributes to the development of chronic kidney disease (CKD) and cardiovascular events. Patients with CKD are especially vulnerable to heat stress for a variety of reasons. A disproportionate percentage of patients with CKD live in poverty, experience homelessness, mental illness, or disabilities, work outside, or are elderly, all demographics that overlap with populations most susceptible to episodes of extreme heat. Therefore, it is reasonable to conclude that exposure to episodes of extreme heat can lead to the progression of CKD and increases morbidity and mortality. Given these concerns, clinicians must be prepared to recognize complications of heat in CKD patients promptly and to help patients appropriately acclimate. We propose the following tips for clinicians to care for their CKD patients effectively during extreme heat days.