SP185DOES A HEAT WAVE IN THE UNITED KINGDOM REPRESENT A SIGNIFICANT HEALTH RISK IN TERMS OF AKI?

Abstract

Introduction and Aims: The Met office's definition of a heat wave is, "when the daily maximum temperature (temp) of more than five consecutive days exceeds the average maximum temp by 5degreeC, the normal period being 1961-1990". In August 2003 there was a heat wave in the UK which lasted ten days, this was associated with an increase in mortality during that period; 2000 deaths were attributed to the heat. NHS England states that the major risk during a heat wave is dehydration and overheating, especially for those with pre-existing co-morbidity seen in the elderly. Aim The aim of this study was to examine the relationship between the incidence of AKI and climatic temp changes. Hypothesis: During periods of very hot weather in the UK the incidence of AKI would increase. Method(s): The Study was conducted one of the warmest counties in the UK. Data on the weather were taken from a local weather web site from 01-01-2012 - 31-12-2015. Serum creatinine results were extracted from the regional pathology data base. Patterns of testing were examined and compared to those when the temp was >=25 degreec and during a period defined using the met office definition of a heat wave. Simple correlations between number of tests, numbers of AKI and temp were performed. Finally, data from the local AKI database was matched to temp data. The data was weighted to correct for number of serum creatinine tests per day. Logistic regression analysis examined the independent effect of temp on the odds of having an AKI during hot weather. Result(s): There were 9 Heat waves during the study period. 157 days were the maximum temp was >=25degreec. The mean number of tests at the weekend was less than the week however the pattern of testing did not change when split when split into groups of < 10degreec, 10degreec - 25degree c and >= 25degreec or when there was a heat wave (figure 1). There was no significant difference between the means for numbers of tests (1833.2, 1848.6 and 1888.4) and numbers of AKI (62.0, 57.4, 59.2, respectively, figure 2). There was no correlation between maximum temp on the day of the request, the day before and three days before and the incidence of AKI (figure 3). The multivariable analysis did not demonstrate an association with incidence and stage of AKI having corrected for baseline GFR and Charlson co-morbidity score (coefficient 0.001. CI 0.00 - 0.00). Conclusion(s): This study shows that there is no increased risk of AKI during summer heat-waves in England. A possible explanation for this is that the temps in the UK are insufficiently high for long periods of time for the development of AKI, since countries with hotter climates have suggested a link. However it does show a small significant relationship between increased testing and incident AKI and colder weather. This could be attributed to exacerbation of co-morbid conditions during winter months in vulnerable adults who become too unwell or confused to remain adequately hydrated. (Figure presented).