MANAGING HEAT STRESS AND KIDNEY INJURY: DR VINOD KUMAR

Heat stress is a condition that develops when the body temperature rises above the person's ability for heat loss, which is typically 104 degrees Fahrenheit, and when humidity levels are higher than 70%. Heat cramps, heat exhaustion, heat rash, or heat stroke are all included. Heavy sweat and a rapid pulse are symptoms of heat exhaustion.

If not treated promptly, it can lead to heat stroke which is a severe life-threatening condition. When humidity is high, sweating becomes less effective at dissipating heat and the core body temperature begins to rise. Kidneys are typically among the many organs that are impacted by heat illness. High-risk groups for heat stroke include young children and infants, teenage athletes, and elderly people with underlying illnesses like heart disease.

Heat stroke causes due to exposure to extreme heat resulting in hyperthermia with a temperature of more than 104°F, which can lead to delirium, coma, seizures and multi-organ failure. Heat stroke can occur during extreme heat waves and also in association with extreme exercise or labour, which is called Exertional heat stroke.

Kidneys are impacted by heat stress in various ways. It primarily results in acute kidney injury, severe dehydration, low blood pressure, and reduced perfusion to the kidneys. Heat stress can result in rhabdomyolysis, which breaks down muscle tissue and releases a protein called myoglobin that can harm the tubules inside the kidneys. Acute kidney injury can result from heart failure and shock during severe heat stroke episodes.

The kidneys may suffer a direct inflammatory injury from heat. Higher core temperatures, dehydration, longer work duration, muscle-damaging exercise, and beverage consumption worsen heat stress-related kidney injury.

Many manual labourers who work in a variety of hot climates around the world can develop chronic kidney disease, also known as "heat stress nephropathy." It happens due to repeated episodes of acute kidney injury due to subclinical or clinical heat stroke.

Heat Stress also predisposes to the formation of kidney stones. Due to low urine volume and urinary concentration brought on by heat stress, stones are more likely to form. Underhydration may also contribute to urinary tract infections.

To counter heat stress, immediately shift the patient suspected to have heat stress to a cooler environment. External cooling by means of mists plus fan, cool shower or put in a cool tub of water. Ice packs to the head and neck, remove clothing and apply cool compresses. An ice bath can also be used. Adequate hydration is also very important.