Climate change and pollution: impact on blood pressure and kidneys

Climate change and pollution have become major burdens for human health, and they will represent a growing issue in the future if nothing is planned to limit them. Epidemiologic evidence has clearly demonstrated significant associations between exposure to extreme climatic events, such as heat stress and pollution (air, noise, or toxic substances) and the occurrence of cardiovascular events. Indeed, climate and pollution have been shown to interfere with blood pressure regulation and to increase the risk of hypertension, and hence of cardiovascular complications, such as stroke, myocardial infarction, peripheral artery disease, or heart failure. For a long time, little attention has been paid to the renal impact of climate change and pollution, even though kidney function is very sensitive to these types of insults and mediates several of the clinical consequences of heat stress or pollution. Recently, more emphasis has been placed on the bidirectional relationship between the environment and kidney diseases. On the one hand, environmental change has an impact on the patterns of kidney diseases, and on the other hand, kidney replacement therapies, mainly chronic hemodialysis, are responsible for substantial carbon emissions and resource depletion. The purpose of this review is to discuss these kidney‑related issues to increase awareness of health care providers.