Occupational heat exposure is linked to the development of kidney injury and disease in individuals, especially the ones who perform physically demanding work in the heat. Today,The Pioneer’s K. Ramya Sree brings to you a detailed analysis on these heat strokes and how they could lead to several chronic kidney issues.
Our kidneys are presumably vulnerable to the continual extreme heat as a result of global warming. We have been now witnessing a new era of the climate health crisis during which the known diseases are being exacerbated and new diseases are coming to light. Chronic kidney disease is likely to be just one of many heat-sensitive illnesses that will be unmasked and accelerated by climate change.
Global warming is on the rise, the Intergovernmental Panel on Climate Change (IPCC) projects that the global temperature is likely to rise by 2 degrees by 2050 and by 3.5 degrees by the end of this century, which could mean apocalypse for the human race.
Experts say that heat stroke has a detrimental effect on kidney health.
Heat exposure and dehydration have been implicated in epidemics of Chronic Kidney disease in Latin America and even in Andhra Pradesh. Apart from this heat exposure has been linked to AKI (sudden onset of kidney injury); kidney stones and urinary tract infections (UTI).
Now wondering what this heat stroke is? Dr. Sashi Kiran A, consultant nephrologist, Yashoda Hospitals, Hyderabad, explained, “Heat stroke is a condition where the temperature of the body increases up to 1040F in the absence of infection.Heat stroke is an emergency as it can lead to death. People who work in hot and humid climates are prone to develop heat stroke if they don’t consume enough fluids. People of extreme ages like infants and elderly who don’t have access to water are prone to develop this condition.”
Heat stroke results from the exposure to the extreme heat resulting in hyperthermia with the temperature of more than 104 degree F, that could lead to delirium, coma, seizures and multi-organ failure.
“In recent times, we have seen a number of heat waves in our country. Heat waves can lead to AKI by causing heat strokes. Old age individuals and those with obesity and diabetes are particularly prone to these. This kind of kidney injury often needs dialysis and often improves with treatment. Also, this can be prevented by avoiding heat exposure and drinking a good amount of water,” said Dr Arpit, consultant nephrologist, Ujala Cygnus Group of Hospitals.
Heat stress related kidney injury is worsened by higher core temperatures, dehydration, longer work duration, muscle damaging exercise, and consumption of beverages. Explaining how heat stress affects kidneys, Dr. Vinod Kumar, consultant nephrologist and Renal Transplantation, Aster RV Hospital, said, “Predominantly it causes severe dehydration, low blood pressure and reduced perfusion to the kidneys resulting in acute kidney injury. Heat stress can cause breakdown of muscle tissue (rhabdomyolysis) which releases a protein called myoglobin that can cause damage to the tubules inside the kidneys. During severe episodes of heat stroke, heart failure and shock can cause acute kidney injury.”
Dr Vinod advised the immediate action to be done when a person suffers heat stroke and that is: “Immediately shift the patient suspected to have heat stress to a cooler environment. External cooling by means of mists plus fan, cool shower or put in cool tub of water, ice packs to the head and neck, remove clothing and applying cool compresses, ice bath can also be used. Adequate hydration is also very important.”
It has also been noted around the world including in India that farmers working in extreme heat especially in sugarcane farms have a high rate of CKD (Kidney disease of long duration). Recurrent dehydration and then rehydration with soft drinks or sugarcane juice has been implicated as the risk factor for this. Unfortunately, this kind of kidney damage cannot be reversed and the patient often needs to be put on dialysis or undergo renal transplant.
Dr. V Kavita, AVP Lab Operations TN & APT, Metropolis Healthcare Ltd, explained about the issues a patient faces with poor or unhealthy kidneys. She said, “Kidneys help in normal functioning of the body by removing waste products, maintaining blood pressure and bone health. A patient with an unhealthy kidney faces a wide range of health problems from tiredness, nausea, vomiting, decrease in urine output, anaemia and bone disease depending on the severity of the illness.”
She also listed some less known facts about poor kidneys, and they are: “Use of over the counter pain killer medications can cause kidney failure which goes unidentified till there is complete cessation of urine output. Maintaining normal blood sugar and blood pressure levels helps in keeping kidneys healthy. Excess use of protein powder, fat burner pills can damage the kidney at a slow and steady pace.”
The best way to protect kidneys is to ensure that heat stroke doesn’t occur. This can be achieved by the following measures:
.Wearing light and loosely fitting clothes
.Consuming adequate fluids
.Avoid diuretics
.Avoiding direct sun or heat exposure
.Avoid strenuous activities in hot weather
.Never leave anyone alone in a parked car
Deadly complications of heat stroke:
.AKI
.Acute respiratory distress syndrome
.DIC
.Hepatic failure
.Hypoglycemia
.Rhabdomyolysis
.Hypoglycemia
.Seizures
.Death
