Background: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and kidney stone presentation is unknown.
Objectives: Our objective was to estimate associations between mean daily temperature and kidney stone presentation according to lag time and temperatures.
Methods: Using a time-series design and distributed lag nonlinear models, we estimated the relative risk (RR) of kidney stone presentation associated with mean daily temperatures, including cumulative RR for a 20-day period, and RR for individual daily lags through 20 days. Our analysis used data from the MarketScan Commercial Claims database for 60,433 patients who sought medical evaluation or treatment of kidney stones from 2005–2011 in the U.S. cities of Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Los Angeles, California; and Philadelphia, Pennsylvania.
Results: Associations between mean daily temperature and kidney stone presentation were not monotonic, and there was variation in the exposure–response curve shapes and the strength of associations at different temperatures. However, in most cases RRs increased for temperatures above the reference value of 10°C. The cumulative RR for a daily mean temperature of 30°C versus 10°C was 1.38 in Atlanta (95% CI: 1.07, 1.79), 1.37 in Chicago (95% CI: 1.07, 1.76), 1.36 in Dallas (95% CI: 1.10, 1.69), 1.11 in Los Angeles (95% CI: 0.73, 1.68), and 1.47 in Philadelphia (95% CI: 1.00, 2.17). Kidney stone presentations also were positively associated with temperatures < 2°C in Atlanta, and < 10°C in Chicago and Philadelphia. In four cities, the strongest association between kidney stone presentation and a daily mean temperature of 30°C versus 10°C was estimated for lags of ≤ 3 days.
Conclusions: In general, kidney stone presentations increased with higher daily mean temperatures, with the strongest associations estimated for lags of only a few days. These findings further support an adverse effect of high temperatures on nephrolithiasis.
1Division of Urology, Department of Surgery, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; 2Division of Urology, Department of Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania, USA; 3Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; 4Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, England; 5Department of Urology, University of California, Los Angeles, Los Angeles, California; 6RAND Corporation, Santa Monica, California, USA; 7Department of Marine and Coastal Sciences, Rutgers University, New Brunswick, New Jersey, USA; 8Division of Earth Sciences and Earth Observatory of Singapore, Nanyang Technological University, Singapore; 9Department of Epidemiology and Biostatistics, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania, USA; 10Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
Recommended Citation:
Gregory E. Tasian,1,2,et al. Daily Mean Temperature and Clinical Kidney Stone Presentation in Five U.S. Metropolitan Areas: A Time-Series Analysis[J]. Environmental Health Perspectives,2014-01-01,Volume 122(Issue 10):1081