Effect of Ambient Temperature on Kidney Function

Extreme ambient temperatures - particularly occupational heat stress - are a major driver of renal dysfunction in resource-limited settings. Such exposures heighten the risk of nephrolithiasis and acute kidney injury (AKI), contributing substantially to global morbidity.

This review outlines the impact of rising environmental temperatures on renal physiology and the risk of heat-related AKI, chronic kidney disease of uncertain etiology (CKDu), and nephrolithiasis. Prolonged heat exposure promotes water and electrolyte losses, reduces renal perfusion, and activates oxidative and inflammatory pathways, culminating in heat stress nephropathy or CKDu in vulnerable agricultural populations.

(1) Extreme temperatures disrupt renal homeostasis via distinct mechanisms: heat stress induces water and electrolyte losses, hypoperfusion, oxidative stress, and inflammation, whereas cold stress provokes vasoconstriction, cold diuresis, and potential ischemic injury. (2) Sustained thermal stress impairs glomerular filtration and tubular function, increasing susceptibility to AKI, nephrolithiasis, and long-term renal dysfunction. (3) Elderly individuals, patients with CKD, and agricultural workers exposed to extreme weather represent high-risk groups due to limited physiologic reserve, inadequate hydration, and concurrent medication use that blunts renal adaptive responses to temperature variation.