Association of Temperature and Ethnicity with End-Stage Renal Disease of Unknown Cause: A Brief Report

Internationally, end-stage renal disease of unknown cause (ESRDuc) has been linked to heat exposure, particularly as Mesoamerican nephropathy in Central America, yet its relationship with temperature in the United States remains understudied. Utilizing state-level ESRDuc incidence data from the United States Renal Data System (2010–2019), here we showed that each 1°F increase in average annual temperature was associated with a 2% increase in ESRDuc incidence (IRR=1.02; 95% CI, 1.00–1.04; p= 0.018); each one-percentage-point increase in a state's Hispanic population share was associated with a 23% increase in ESRDuc incidence (IRR=1.23; 95% CI, 1.13–1.34; p<0.001). Both temperature and proportion of Hispanic population were independently associated with increased ESRDuc incidence in the United States, suggesting that heat-related kidney injury, previously described in other geographic regions, may also be relevant in the US.