The impact of daily temperature on renal disease incidence: an ecological study

Borg, Matthew; Bi, Peng; Nitschke, Monika; Williams, Susan; McDonald, Stephen

doi:10.1186/s12940-017-0331-4

Environmental Health

Table 5 Incidence rate ratios (IRRs) for renal outcomes and daily temperature for lag periods (0–5 days)

From: The impact of daily temperature on renal disease incidence: an ecological study

Temperature	Admission data	Disease	Lag period	IRR	95% CI			P-value
Maximum	ED	Total renal	0 days	1.004	1.002	–	1.005	<0.001
		disease	1 day	1.006	1.004	–	1.008	<0.001
			2 days	1.006	1.004	–	1.008	<0.001
			3 days	1.005	1.003	–	1.007	<0.001
			4 days	1.004	1.002	–	1.005	<0.001
			5 days	1.003	1.001	–	1.005	0.001
		Urolithiasis	0 days	1.006	1.003	–	1.010	<0.001
			1 day	1.011	1.007	–	1.014	<0.001
			2 days	1.011	1.008	–	1.015	<0.001
			3 days	1.010	1.006	–	1.013	<0.001
			4 days	1.006	1.003	–	1.010	<0.001
			5 days	1.004	1.001	–	1.008	0.012
		Renal failure	0 days	1.018	1.012	–	1.024	<0.001
			1 day	1.024	1.018	–	1.030	<0.001
			2 days	1.018	1.011	–	1.024	<0.001
			3 days	1.011	1.005	–	1.017	0.001
			4 days	1.008	1.002	–	1.014	0.012
			5 days	1.007	1.001	–	1.013	0.024
		AKI	0 days	1.023	1.016	–	1.031	<0.001
			1 day	1.031	1.023	–	1.039	<0.001
			2 days	1.023	1.015	–	1.030	<0.001
			3 days	1.014	1.006	–	1.022	<0.001
			4 days	1.012	1.004	–	1.020	0.002
			5 days	1.008	1.000	–	1.016	0.047
		CKD	0 days	1.005	0.994	–	1.016	0.365
			1 day	1.012	1.001	–	1.024	0.03
			2 days	1.010	0.999	–	1.021	0.085
			3 days	1.006	0.995	–	1.018	0.263
			4 days	1.001	0.990	–	1.013	0.802
			5 days	1.004	0.993	–	1.016	0.447
		UTI	0 days	1.001	0.999	–	1.003	0.411
			1 day	1.002	1.000	–	1.004	0.042
			2 days	1.002	1.000	–	1.004	0.043
			3 days	1.003	1.000	–	1.005	0.02
			4 days	1.002	1.000	–	1.004	0.114
			5 days	1.002	1.000	–	1.004	0.08
		Lower UTI	0 days	1.001	0.999	–	1.003	0.507
			1 day	1.002	1.000	–	1.004	0.078
			2 days	1.002	1.000	–	1.004	0.094
			3 days	1.003	1.000	–	1.005	0.018
			4 days	1.002	1.000	–	1.004	0.081
			5 days	1.002	1.000	–	1.004	0.086
		Pyelonephritis	0 days	1.002	0.995	–	1.009	0.547
			1 day	1.004	0.997	–	1.010	0.272
			2 days	1.005	0.998	–	1.011	0.184
			3 days	1.001	0.994	–	1.008	0.761
			4 days	0.999	0.993	–	1.006	0.868
			5 days	1.001	0.995	–	1.008	0.682
	Inpatient	Total renal	0 days	1.006	1.004	–	1.009	<0.001
		disease	1 day	1.007	1.005	–	1.010	<0.001
			2 days	1.007	1.004	–	1.009	<0.001
			3 days	1.006	1.004	–	1.009	<0.001
			4 days	1.003	1.000	–	1.005	0.035
			5 days	0.999	0.997	–	1.002	0.562
		Urolithiasis	0 days	1.007	1.002	–	1.012	0.009
			1 day	1.010	1.005	–	1.015	<0.001
			2 days	1.011	1.006	–	1.016	<0.001
			3 days	1.010	1.005	–	1.015	<0.001
			4 days	1.006	1.000	–	1.011	0.04
			5 days	0.999	0.993	–	1.004	0.631
		Renal failure	0 days	1.016	1.010	–	1.022	<0.001
			1 day	1.016	1.010	–	1.022	<0.001
			2 days	1.015	1.009	–	1.021	<0.001
			3 days	1.014	1.008	–	1.020	<0.001
			4 days	1.007	1.001	–	1.013	0.015
			5 days	1.000	0.994	–	1.006	0.993
		AKI	0 days	1.020	1.013	–	1.026	<0.001
			1 day	1.021	1.014	–	1.027	<0.001
			2 days	1.018	1.011	–	1.025	<0.001
			3 days	1.014	1.007	–	1.020	<0.001
			4 days	1.007	1.001	–	1.014	0.034
			5 days	1.000	0.994	–	1.007	0.955
		CKD	0 days	1.006	0.997	–	1.014	0.171
			1 day	1.005	0.997	–	1.014	0.208
			2 days	1.009	1.000	–	1.018	0.042
			3 days	1.010	1.001	–	1.018	0.023
			4 days	1.003	0.995	–	1.012	0.449
			5 days	0.996	0.987	–	1.004	0.317
		UTI	0 days	1.004	1.001	–	1.008	0.005
			1 day	1.005	1.001	–	1.008	0.004
			2 days	1.004	1.000	–	1.007	0.027
			3 days	1.003	1.000	–	1.006	0.044
			4 days	1.000	0.997	–	1.003	0.908
			5 days	0.999	0.996	–	1.002	0.548
		Lower UTI	0 days	1.005	1.002	–	1.009	0.002
			1 day	1.005	1.002	–	1.009	0.002
			2 days	1.004	1.000	–	1.007	0.028
			3 days	1.003	1.000	–	1.007	0.055
			4 days	1.000	0.997	–	1.004	0.866
			5 days	0.999	0.996	–	1.003	0.608
		Pyelonephritis	0 days	1.002	0.996	–	1.009	0.472
			1 day	1.003	0.996	–	1.009	0.47
			2 days	1.004	0.997	–	1.010	0.314
			3 days	1.004	0.997	–	1.010	0.307
			4 days	0.999	0.993	–	1.006	0.864
			5 days	0.997	0.990	–	1.004	0.386
Minimum	ED	Total renal	0 days	1.009	1.006	–	1.011	<0.001
		disease	1 day	1.008	1.005	–	1.010	<0.001
			2 days	1.007	1.005	–	1.010	<0.001
			3 days	1.005	1.003	–	1.008	<0.001
			4 days	1.004	1.002	–	1.007	0.001
			5 days	1.002	1.000	–	1.005	0.082
		Urolithiasis	0 days	1.015	1.010	–	1.020	<0.001
			1 day	1.015	1.010	–	1.020	<0.001
			2 days	1.014	1.009	–	1.019	<0.001
			3 days	1.009	1.004	–	1.014	<0.001
			4 days	1.006	1.001	–	1.011	0.022
			5 days	1.003	0.998	–	1.008	0.196
		Renal failure	0 days	1.030	1.022	–	1.039	<0.001
			1 day	1.027	1.019	–	1.036	<0.001
			2 days	1.018	1.009	–	1.026	<0.001
			3 days	1.013	1.005	–	1.022	0.002
			4 days	1.012	1.003	–	1.021	0.006
			5 days	1.009	1.001	–	1.018	0.036
		AKI	0 days	1.037	1.026	–	1.048	<0.001
			1 day	1.035	1.025	–	1.046	<0.001
			2 days	1.021	1.010	–	1.032	<0.001
			3 days	1.017	1.006	–	1.027	0.003
			4 days	1.016	1.005	–	1.027	0.005
			5 days	1.012	1.001	–	1.023	0.029
		CKD	0 days	1.017	1.001	–	1.033	0.036
			1 day	1.018	1.002	–	1.034	0.024
			2 days	1.017	1.002	–	1.033	0.031
			3 days	1.008	0.992	–	1.024	0.338
			4 days	1.002	0.986	–	1.018	0.83
			5 days	1.000	0.984	–	1.016	0.98
		UTI	0 days	1.004	1.000	–	1.007	0.023
			1 day	1.002	0.999	–	1.005	0.116
			2 days	1.003	1.000	–	1.006	0.06
			3 days	1.002	0.999	–	1.005	0.138
			4 days	1.003	1.000	–	1.006	0.082
			5 days	1.001	0.998	–	1.004	0.562
		Lower UTI	0 days	1.003	1.000	–	1.006	0.045
			1 day	1.002	0.999	–	1.005	0.216
			2 days	1.003	1.000	–	1.006	0.087
			3 days	1.002	0.999	–	1.006	0.142
			4 days	1.002	0.999	–	1.006	0.153
			5 days	1.001	0.997	–	1.004	0.706
		Pyelonephritis	0 days	1.006	0.996	–	1.015	0.245
			1 day	1.006	0.996	–	1.015	0.232
			2 days	1.004	0.995	–	1.013	0.41
			3 days	1.002	0.992	–	1.011	0.752
			4 days	1.006	0.996	–	1.015	0.244
			5 days	1.003	0.994	–	1.013	0.495
	Inpatient	Total renal	0 days	1.012	1.008	–	1.015	<0.001
		disease	1 day	1.010	1.007	–	1.014	<0.001
			2 days	1.008	1.004	–	1.011	<0.001
			3 days	1.004	1.001	–	1.008	0.018
			4 days	1.000	0.997	–	1.004	0.987
			5 days	1.000	0.996	–	1.003	0.942
		Urolithiasis	0 days	1.014	1.007	–	1.022	<0.001
			1 day	1.012	1.004	–	1.019	0.002
			2 days	1.007	1.000	–	1.015	0.062
			3 days	1.006	0.998	–	1.013	0.147
			4 days	0.997	0.990	–	1.005	0.514
			5 days	0.997	0.989	–	1.004	0.39
		Renal failure	0 days	1.024	1.015	–	1.032	<0.001
			1 day	1.020	1.012	–	1.029	<0.001
			2 days	1.016	1.008	–	1.025	<0.001
			3 days	1.010	1.002	–	1.019	0.016
			4 days	1.003	0.995	–	1.012	0.431
			5 days	1.002	0.993	–	1.010	0.695
		AKI	0 days	1.028	1.019	–	1.038	<0.001
			1 day	1.025	1.015	–	1.034	<0.001
			2 days	1.018	1.008	–	1.027	<0.001
			3 days	1.008	0.999	–	1.018	0.082
			4 days	1.003	0.994	–	1.013	0.513
			5 days	1.003	0.994	–	1.013	0.521
		CKD	0 days	1.011	0.999	–	1.023	0.068
			1 day	1.012	1.000	–	1.024	0.059
			2 days	1.010	0.998	–	1.022	0.089
			3 days	1.006	0.994	–	1.018	0.361
			4 days	0.999	0.987	–	1.011	0.884
			5 days	0.999	0.987	–	1.011	0.859
		UTI	0 days	1.008	1.003	–	1.012	<0.001
			1 day	1.006	1.002	–	1.011	0.007
			2 days	1.004	1.000	–	1.009	0.054
			3 days	1.001	0.997	–	1.006	0.633
			4 days	0.999	0.995	–	1.004	0.698
			5 days	1.000	0.995	–	1.004	0.903
		Lower UTI	0 days	1.009	1.004	–	1.014	<0.001
			1 day	1.006	1.001	–	1.011	0.017
			2 days	1.004	0.999	–	1.009	0.126
			3 days	1.001	0.996	–	1.006	0.677
			4 days	0.999	0.994	–	1.004	0.624
			5 days	1.000	0.995	–	1.005	0.986
		Pyelonephritis	0 days	1.005	0.995	–	1.014	0.346
			1 day	1.008	0.998	–	1.018	0.11
			2 days	1.008	0.998	–	1.017	0.114
			3 days	1.000	0.990	–	1.010	0.986
			4 days	0.998	0.988	–	1.007	0.62
			5 days	0.999	0.989	–	1.009	0.833
Average	ED	Total renal	0 days	1.007	1.004	–	1.009	<0.001
		disease	1 day	1.009	1.006	–	1.011	<0.001
			2 days	1.008	1.006	–	1.010	<0.001
			3 days	1.007	1.004	–	1.009	<0.001
			4 days	1.005	1.003	–	1.007	<0.001
			5 days	1.004	1.001	–	1.006	0.002
		Urolithiasis	0 days	1.012	1.007	–	1.016	<0.001
			1 day	1.015	1.011	–	1.020	<0.001
			2 days	1.016	1.011	–	1.020	<0.001
			3 days	1.012	1.007	–	1.016	<0.001
			4 days	1.008	1.003	–	1.012	0.001
			5 days	1.005	1.001	–	1.010	0.024
		Renal failure	0 days	1.028	1.020	–	1.036	<0.001
			1 day	1.032	1.024	–	1.040	<0.001
			2 days	1.022	1.014	–	1.030	<0.001
			3 days	1.014	1.007	–	1.022	<0.001
			4 days	1.012	1.004	–	1.020	0.004
			5 days	1.010	1.002	–	1.018	0.015
		AKI	0 days	1.035	1.025	–	1.045	<0.001
			1 day	1.041	1.031	–	1.051	<0.001
			2 days	1.028	1.018	–	1.038	<0.001
			3 days	1.019	1.009	–	1.029	<0.001
			4 days	1.017	1.007	–	1.027	0.001
			5 days	1.012	1.002	–	1.022	0.021
		CKD	0 days	1.011	0.997	–	1.026	0.125
			1 day	1.018	1.004	–	1.033	0.014
			2 days	1.016	1.001	–	1.030	0.034
			3 days	1.009	0.994	–	1.023	0.248
			4 days	1.002	0.987	–	1.017	0.784
			5 days	1.004	0.989	–	1.018	0.621
		UTI	0 days	1.002	0.999	–	1.005	0.121
			1 day	1.003	1.000	–	1.006	0.041
			2 days	1.003	1.000	–	1.006	0.03
			3 days	1.003	1.000	–	1.006	0.028
			4 days	1.003	1.000	–	1.005	0.063
			5 days	1.002	0.999	–	1.005	0.165
		Lower UTI	0 days	1.002	0.999	–	1.005	0.184
			1 day	1.003	1.000	–	1.006	0.085
			2 days	1.003	1.000	–	1.006	0.063
			3 days	1.003	1.000	–	1.006	0.026
			4 days	1.003	1.000	–	1.006	0.068
			5 days	1.002	0.999	–	1.005	0.203
		Pyelonephritis	0 days	1.004	0.995	–	1.013	0.364
			1 day	1.006	0.997	–	1.014	0.207
			2 days	1.005	0.997	–	1.014	0.215
			3 days	1.002	0.993	–	1.010	0.732
			4 days	1.002	0.993	–	1.011	0.67
			5 days	1.003	0.994	–	1.011	0.564
	Inpatient	Total renal	0 days	1.010	1.007	–	1.013	<0.001
		disease	1 day	1.011	1.007	–	1.014	<0.001
			2 days	1.009	1.006	–	1.012	<0.001
			3 days	1.007	1.004	–	1.010	<0.001
			4 days	1.002	0.999	–	1.005	0.171
			5 days	0.999	0.996	–	1.003	0.689
		Urolithiasis	0 days	1.012	1.005	–	1.019	0.001
			1 day	1.013	1.007	–	1.020	<0.001
			2 days	1.012	1.005	–	1.019	<0.001
			3 days	1.011	1.004	–	1.018	0.002
			4 days	1.004	0.997	–	1.011	0.297
			5 days	0.998	0.991	–	1.004	0.483
		Renal failure	0 days	1.023	1.016	–	1.031	<0.001
			1 day	1.022	1.014	–	1.029	<0.001
			2 days	1.019	1.012	–	1.027	<0.001
			3 days	1.016	1.008	–	1.024	<0.001
			4 days	1.008	1.000	–	1.015	0.053
			5 days	1.001	0.993	–	1.008	0.864
		AKI	0 days	1.029	1.020	–	1.037	<0.001
			1 day	1.028	1.019	–	1.036	<0.001
			2 days	1.022	1.014	–	1.031	<0.001
			3 days	1.015	1.006	–	1.024	0.001
			4 days	1.007	0.999	–	1.016	0.096
			5 days	1.001	0.993	–	1.010	0.751
		CKD	0 days	1.010	0.999	–	1.021	0.087
			1 day	1.010	0.998	–	1.021	0.092
			2 days	1.012	1.001	–	1.023	0.037
			3 days	1.011	1.000	–	1.022	0.058
			4 days	1.002	0.991	–	1.014	0.679
			5 days	0.996	0.985	–	1.007	0.466
		UTI	0 days	1.007	1.003	–	1.011	0.001
			1 day	1.006	1.002	–	1.010	0.002
			2 days	1.005	1.001	–	1.009	0.02
			3 days	1.003	0.999	–	1.007	0.129
			4 days	1.000	0.996	–	1.004	0.906
			5 days	0.999	0.995	–	1.003	0.663
		Lower UTI	0 days	1.008	1.004	–	1.013	<0.001
			1 day	1.007	1.003	–	1.012	0.002
			2 days	1.005	1.000	–	1.009	0.033
			3 days	1.003	0.999	–	1.008	0.154
			4 days	1.000	0.995	–	1.004	0.901
			5 days	0.999	0.995	–	1.004	0.735
		Pyelonephritis	0 days	1.004	0.995	–	1.013	0.378
			1 day	1.005	0.997	–	1.014	0.229
			2 days	1.006	0.997	–	1.015	0.168
			3 days	1.003	0.994	–	1.012	0.501
			4 days	0.998	0.990	–	1.007	0.724
			5 days	0.997	0.988	–	1.006	0.526

Estimated incidence rate ratios (IRRs) and associated 95% confidence intervals and P-values for daily admissions for renal diseases in relation to an increase in daily maximum temperature per 1°C over lag 0–5 days during the warm seasons (October – March) in Adelaide from 1 July 2003 to 31 March 2014. Both emergency department (ED) and inpatient admissions were included. The associated lag periods with the highest IRR value (rounded to 3 decimal figures) and are statistically significant are underlined

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