Effect of hot weather on kidney

In Central America and South Asia, thousands of working-age adults died of uremia of unknown causes. Because the etiology of CKD is not clear, it is called "chronic kidney disease with unknown cause (CKDu)".

There have been many kinds of kidney diseases with unknown causes in history. For example, during World War II, there was a kidney disease caused by a toxin in the Balkans of Europe, but the cause was unknown at that time, so it could only be called "Balkan nephropathy". Later, it was found to be "aristolochic acid nephropathy" because of excessive intake of aristolochic acid (a component of nephrotoxic herbs).

Most nephrologists have reached some understandings about unexplained nephropathy, which is currently high in Central America and South Asia: it is related to the high local temperature.

What's the matter, the kidney can still be "hot" to get sick?

High temperature weather will not directly lead to kidney disease. After all, we are warm-blooded animals, and the human body has a mechanism of automatically regulating body temperature, which is always kept at around 37℃.

But hot weather will bring two inevitable problems: excessive sweating and exposure to pesticides (including pesticides).

It is easy to sweat too much in summer, especially those who work in high temperature environment. After sweating, the kidneys are afraid of water shortage.

The kidneys are full of blood and water. To put it bluntly, the kidney is "dirty water" (so it can continuously produce urine). Very sensitive to the sufficiency of qi and blood. As long as the qi and blood are insufficient, it will be damaged.

If you sweat too much (such as working at high temperature for a long time, steaming sauna, etc.). ), but if you don't replenish water in time, the blood circulation in the body will be reduced, the kidneys will be ischemic and anoxic, and they will "wither" because of lack of nutrition. It is characterized by increased serum creatinine, decreased renal function and renal atrophy, leading to renal failure.

The Journal of Clinical Nephrology published a case: A 56-year-old aunt sprayed insecticide (deltamethrin) at home and stayed indoors for 2 hours after spraying, resulting in a high serum creatinine of 655 umol/L.

Nature Reviews Nephrology also published a study, and found a special pathological change in the kidney tissue of patients engaged in pesticide spraying, which is similar to the change of calcineurin signal in patients exposed to other nephrotoxic drugs.

We are not completely sure that this unexplained nephropathy is caused by a lot of sweating and pesticides. The more likely truth is that a large number of sweating, pesticides, infections and nephrotoxic drugs have led to the high incidence of this kind of kidney disease. New England, the world's top medical journal, made a special report on this, and the results also supported the above causes.

Another phenomenon provides evidence for the cause: the high incidence of unexplained nephropathy is in agricultural areas, not cities. This gives us a hint: insufficient renal blood perfusion caused by sweating and physical labor at high temperature, and nephrotoxic substances exposed when spraying pesticides are more likely to be the main causes of unexplained nephropathy.

1. When using pesticides, take protective measures, wear gloves and masks to reduce contact, and leave after spraying. If spraying indoors, open the window and ventilate for at least half an hour before returning.

2. Friends who work and exercise in a high temperature environment must bring enough water and replenish water in time after sweating.

If serum creatinine rises after exposure to pesticides or excessive sweating, you should go to the nephrology department as soon as possible.