Heat and kidney disease
Extreme heat is one of the most direct routes by which a changing climate harms the kidneys, from acute injury to chronic kidney disease of non-traditional origin.
How heat harms the kidneys
Kidney disease already affects approximately one in eight people globally and is projected to become the fifth leading cause of death by 2040. Extreme heat increases the risk of dehydration, hypovolaemia and thermal stress, which elevates the risk of heat-related kidney diseases such as acute kidney injury, kidney stones and accelerated chronic kidney disease.
Chronic kidney disease of non-traditional origin
Recurrent heat exposure, dehydration and strenuous physical activity are central drivers of CKD of non-traditional origin, particularly in outdoor workers in tropical regions. Repeated subclinical episodes of heat-stress kidney injury might accumulate into progressive CKD even in otherwise healthy individuals.
Who is most at risk
Outdoor and agricultural workers in tropical regions face chronic heat and dehydration implicated in CKD of non-traditional origin. Children are vulnerable from before birth, during crucial periods of barrier maturation, immune development and organogenesis. Pregnancy amplifies vulnerability, with heat exposure increasing risks of preterm birth and gestational hypertension. Older adults and people with existing kidney disease face increased risk from reduced thermoregulatory capacity, and the largest burden falls on low-income and middle-income regions where cooling, hydration and healthcare infrastructure are scarce.
What helps
The most immediately actionable responses are upstream: occupational heat protection such as shaded rest breaks and revised work–rest cycles, secure access to safe water, and exposure reduction. Non-pharmacological interventions including therapeutic exercise and hydration strategies are an active area of study within the group.
Evidence status. The link between cumulative heat exposure and progressive kidney injury is biologically plausible and supported by occupational epidemiology, but the hypothesis that repeated subclinical injury accumulates into CKD still requires confirmation in prospective cohorts.
Key references
- Adalat S, Giannakou K, Valderrama B, et al. Global environmental change and the gut–kidney–brain axis: a review and framework of vulnerability and resilience. The Lancet Planetary Health (2026). doi:10.1016/j.lanplh.2026.101453
- Adalat S, Hajat S, Ikiz B. Climate change has serious implications for children's brain health. BMJ (2024). doi:10.1136/bmj.q1588