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Published on: August 9, 2013
Estimating the Association Between Outdoor Temperature and Acute Kidney Injury Using Alternative Case Definitions
Benjamin Rabin1, Rohan D'Souza, E Jennifer Weil
1From the School of Medicine, Emory University, Atlanta, Georgia (B.R.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia (B.R.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia (R.D'S., H.H.C.); Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia (E.J.W.); and Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia (S.E., N.S.).
Objective:
This study aimed to improve estimates of the association between acute kidney injury (AKI) and ambient heat exposure through better case ascertainment and by isolating community-acquired AKI.
Methods:
We conducted a case-crossover study using data on AKI-related emergency department (ED) visits in Atlanta. Daymet meteorology was used to assess exposure. We compared effect estimates for seven approaches (definitions) for identifying AKI.
Results:
There were between 5868 and 64,269 AKI cases depending on the definition. Higher temperatures were associated with AKI for all case definitions. Associations were strongest for cases with an ICD-coded AKI as a primary diagnosis (OR, 1.15; 95% CI, 1.01-1.31). We also observed significant ( P < 0.05) heat associations among cases identified using laboratory results but without an ICD-coded AKI diagnosis.
Conclusions:
Many AKI cases are not diagnosed; these cases are associated with heat.
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